OPEN ENROLLMENT is CLOSED for 2022.  The Next Open Enrollment will begin on November 7, 2022 through November 30, 2022.

Insurance changes and cancellations can only be made mid-year if there is a Qualifying Life Event.  

(Qualifying Life Event include marriage, divorce, birth/adoption, loss of employer sponsored medical coverage/loss of medicaid, and turning 26 and aging off parent's insurance.)

OPPJ Employee Open Enrollment Newsletter




Insurance Forms

FLEXIBLE BENEFITS FORM for pre-tax option for health, dental, vision, and some AFLAC coverages.


HEALTH
BCBS Health Enrollment and Change Form 

BCBS Health Cancellation Form 


DENTAL
MetLife Dental Enrollment and Change Form 

MetLife Dental Cancellation Form 


VISION
GUARDIAN Vision Enrollment and Change Form 

Guardian Vision Cancellation Form 


FSA
FLEXIBLE SPENDING ACCOUNT Enrollment Form


FSA Information Packet


VOLUNTARY LIFE
MetLife VOLUNTARY LIFE INSURANCE 
**Statement of Health Form must be completed with any Voluntary Life Adding coverage or Increasing coverage for EACH Individual Coverage is requested during Open Enrollment.
(For Example: Employee, Spouse, and 1 Child adding/increasing coverage - 3 Statement of Health forms must be completed)

BASIC and VOLUNTARY LIFE Beneficiary Change Form



Search for file type:
 Please click on one of the categories below to see uploaded documents.