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