Open Enrollment


OPEN ENROLLMENT IS MAY 1, 2021 TO MAY 25, 2021!

ALL ENROLLMENT FORMS/CHANGES MUST BE RECEIVED BY JODI WICK, HUMAN RESOURCE ASSISTANT, NO LATER THAN MAY 25, 2021.  IF YOU HAVE ANY QUESTIONS PLEASE EMAIL HER AT JWICK@SAU50.ORG.

The open enrollment period for 2021-2022 benefit elections has begun for all benefit eligible staff.  This is the only time you can make voluntary changes to your medical and/or dental plans for 2021-2022 without a change in life status such as marriage, death, adoption, spouses job loss, etc.

If you do not want to make any changes to your health or dental plan, no action is required on your part.

This is also the only time you can enroll in a Flexible Spending Account for 2021-2022 (Healthcare Flexible Spending Account and/or Dependent Care Flexible Spending Account).  Please note your 2020-2021 Flexible Spending Account will not roll over to 2021-2022.  You will need to complete a new enrollment form if you want to continue with your Flexible Spending Account.

Please find highlighted links below for enrollment forms and informational brochures/flyers

Health and Dental Enrollment Form To be completed if making a change or newly enrolling in a health and/or dental plan.

Dental Only Enrollment Form To be completed if you are enrolling in dental ONLY.

          Helpful Hints When Completing Health and Dental Enrollment Form

Flexible Spending Account - For those employees who wish to enroll and are on the Access Blue New England health plan. 

          Health FSA & Dependent Care FSA Brochure

          List of Eligible Expenses

Flexible Spending Account (Limited Purpose) For those employees who wish to enroll and are on the Lumenos health plan.  Please note you can only use the Healthcare Flexible Spending Account for dental or vision expenses.

          Limited Purpose FSA Brochure for Dental & Vision Only

          List of Eligible Expenses for Limited Purpose FSA


Please find highlighted links below for health/dental/prescription drug summaries and informational brochures/flyers

Please review your CBA or Handbook to see which plans are available to you.

Health Options

Lumenos with Health Savings Account

          Health Savings Account Flyer

Access Blue New England $5 Copay with RX 10/25/40 M10/40/70

Access Blue New England $20 Copay with RX 10/25/40 M10/40/70

Access Blue New England $20 copay with RX 10/20/45

HealthTrust Programs

          Anthem Vision Discount Program

          Aware Recovery

          LiveHealth Online

          Lark Diabetes Prevention Program

          SmartShopper

                
Grand Rounds
 
            Life Resources

Northeast Delta Dental (NEDD) Options

Option 1     Option 2A     Option 3D     Option 4     Option 4A     Option 6A

          NEDD Vision & Hearing Discount Program

               NEDD Benefit Lookup Site

Prescription Drug Plans

RX 10/25/40 M10/40/70

RX 10/20/45

          CVS Caremark Long Term Prescriptions

          CVS Retail Pharmacy Locations

Retiree Forms/Information

Retiree Open Enrollment Notification

Retiree Medical and/or Dental Application

Retiree Annuity Deduction Authorization Form


Mandatory Notices

Primary Care Provider (PCP) or Ob/Gyn Provider Selection

Premium Assistant under Medicaid and the Children’s Health Insurance Program (CHIP)

 

ALL ENROLLMENT FORMS/CHANGES MUST BE RECEIVED BY JODI WICK, HUMAN RESOURCE ASSISTANT NO LATER THAN MAY 25, 2021. IF YOU HAVE ANY QUESTIONS PLEASE EMAIL HER AT JWICK@SAU50.ORG.

 


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