Dates to Remember
January 1 - November 22, 2013
Time frame for you and your spouse to earn the LiveSmart Health Care Incentives. Click here for forms and detailed information LiveSmart Health Care Incentives.
September 2 - 27, 2013
Time frame for you and your spouse to register for the October 30th Annual LiveSmart Health Fair biometric screenings, bone density tests, derma scans, and /or flu shots.
September 2 - 27, 2013
Employees and spouses who are not enrolled in one of the college's medical plans, but who want to complete the online health risk assessment and earn the health care incentives, must contact Sharon Whitmore at firstname.lastname@example.org to register for special access to the assessment.
October 1 - 31
Time frame for Open Enrollment.
October 15, 16, 28, 29
Presentations regarding health insurance changes will be held and assistance with Open Enrollment forms will also be provided.
LiveSmart Health Fair
How to Prepare for the 2013 Health Fair Screenings
October 30 - November 22
Time frame for completing the online Health Assessment
Instructions for Completing the 2013 Online Health Assessment
October 31, 2013
Deadline for submitting Open Enrollment forms
Deadline for submitting Preventive Care Verification forms
Deadline for completing the online Health Assessment
Annual Benefit Open Enrollment
Provides a once-a-year opportunity for you to make changes to your medical, dental, and vision insurance, flexible spending accounts, and/or AFLAC supplemental benefits, as well as add dependents to your health insurance plans. Changes become effective January 1, 2014.
What You Need to Do:
- Know which benefits you are currently enrolled in and what your corresponding payroll deductions are.
- Refer to the Individual Benefit Statement which will be sent to you in the interoffice mail, just prior to October 1, 2013.
- Familiarize yourself with the benefit changes, which will become effective January 1, 2014. Decide if you want to revise any of your benefits in light of these changes.
- A description of the changes is available in the shaded box above.
- Presentations to explain the changes and assist in completing Open Enrollment forms will be held on October 15, 16, 28, and 29, 2013.
- Complete all applicable Open Enrollment forms listed below:
Spousal Insurance Certification Form - 2014
You must complete this form if you plan to provide primary or secondary medical insurance coverage for your spouse in 2014. (This form needs to be completed annually.)
Flexible Spending Account Enrollment Form - 2014
You must complete this form if you plan to contribute to a Flexible Spending Account for un-reimbursed health care or dependent day care expenses in 2014. (This form needs to be completed annually.)
Guardian Dental Full-Time Student Certification Form
Each year that you plan to provide dental insurance coverage for your child, age 19-22, you must complete this form to to certify that he/she is a full-time student.
Medical Mutual of Ohio Adult Dependent Certification Form
Each year that you plan to provide medical insurance coverage for your child, age 26 - 28, you must complete this form to certify that he/she meets the State of Ohio's dependent child criteria.
Health Savings Account Contribution Form - 2014
If you are enrolled in the High Deductible Health Plan (HDHP), you must complete this form each year to indicate whether or not you want to contribute funds to your Health Savings Account.
Medical Insurance Enrollment-Change Form - 2014
If you want to change to a different medical plan for 2014; or if you want to add or cancel medical coverage for a spouse and/or dependent child, you need to complete this form.
Dental Insurance Enrollment-Change Form - 2014
If you want to add or cancel dental coverage for a spouse and/or dependent child for 2014, you need to complete this form.
Vision Insurance Enrollment-Change Form - 2014
If you want to change to a different vision coverage option for 2014; or if you want to add or cancel vision coverage for a spouse and/or dependent child, you need to complete this form.
Life Insurance Enrollment-Change Form
If you want to add life insurance coverage for a spouse and/or dependent child; or if you want to increase/decrease coverage for yourself and/or your dependents, you need to complete this form.
Medical History Statement for Supplemental Life Insurance
If you want to apply for additional life insurance coverage for yourself, you need to complete this form, as well as the Life Insurance Enrollment/Change Form above.
- For additional information on Open Enrollment, check out the Frequently Asked Questions (FAQs) below: