Open Enrollment Benefit Information

2015-2016 Academic Year

Annual Open Enrollment Forms

DUE DATE: Friday, May 15, 2015

More information

All employees working half-time or more must…

  • make your selections about which benefits you will select for the new college year beginning July 1,
  • decide which dependents, if any, you wish to cover, and,
  • choose which plan(s) in which you wish to enroll.


  1. Wednesday, April 15th – Friday, May 15th: Open enrollment period
  2. Monday, April 20th: Benefits Fair from 10:00 a.m.-12 noon and 1:15-3:30 p.m. You may complete your Annual Open Enrollment form and do all your sign-ups or changes for insurance coverage at the annual Benefits Fair in the College Church Fellowship Hall.
  3. Friday, May 15th: the last day to submit your Open Enrollment forms and any insurance application forms to Vickie Miller in Human Resources.


ALL FORMS MUST BE COMPLETED AND SUBMITTED TO VICKIE MILLER BY Friday, May 15th: A new application or cancellation form is needed for any benefit in which you are changing coverage. Changing your Annual Open Enrollment form is one step; a new application or cancellation is needed for the insurance company to know your change of coverage.

Many of the forms are available online from the HR forms page. Download them, fill them in, print them out, and return all forms to the Human Resources department by campus mail to Westlawn 103. You can also stop by the HR department anytime to pick up a form.

Come to the Benefits Fair for detailed information and help filling out the forms. To review your current benefits, please see the employee-elected deductions listed on your online Compensation Statement. We will also have a copy of your current Annual Open Enrollment form available at the Benefits Fair.

Benefits Fair

You may do all your sign-ups at the Benefits Fair Monday, April 20th, from 10:00 a.m.-noon. and 1:15-3:30 p.m. in the College Church Fellowship Hall.

The Benefits Fair on April 20th will feature representatives of most of our benefit providers who can offer assistance in describing products and completing applications. In addition, representatives from TIAA-CREF and Mennonite Retirement Trust will be in attendance to facilitate account enrollment or answer employee questions. The GC Development Office will also have a table and enrollment form this year for convenience in learning about the benefits of donating to Goshen College. A Human Resources table will include Annual Open Enrollment forms and answers to your open enrollment questions. We will have your current year Annual Open Enrollment form available to compare. Please plan to visit each vendor on April 20th at the College Mennonite Church Fellowship Hall.

The following benefits are involved in Open Enrollment:

Health insurance

Employee premiums will depend on employee participation in the Wellness Program and how many of the 4 wellness goals have been met. Employees who choose to opt out of the Wellness Program will pay for 20% of the premium that the college normally pays for a single employee. Please see the Wellness Program for further details about the wellness goals.

The below rates for 2015-16 increased by only 2.9% from last year.  Goshen College will continue to pay the full employee premium as well as half of the premium for dependents for full-time employees.

Single Coverage
Full Family
 $0  $166.69  $456.70  $623.39
College  $520.53  $687.22  $520.53  $687.22
Total  $520.53  $853.91  $977.23  $1,310.61
*Contingent on meeting all wellness goals

In your coverage decision, remember that the rates above are gross deductions. The net cost to you will be 75-80% of these figures due to taking them out of your check pre-tax (tax free).

Dental insurance

The dental insurance rates have not changed for the 2015-2016 college year. Employees pay the full cost of these premiums.

Dental Monthly Premium Cost:

Plan 6b
Employee only  $21.10
Employee + 1 dependent  $48.40
Full Family  $90.10

Vision Service Plan

VSP offers two plans with 4 levels of employee and family coverage. These plans and monthly rates, paid by the employee, are outlined below. The rates have increased for the 2015-2016 college year.

Employee Empl + 1 Empl + Dependents Full Family
Plan B $9.56  $16.09  $16.43  $26.49
Plan C  $14.08  $23.71  $24.20  $39.02

Both plans offer coverage with a co-payment for an examination by an optometrist and new lenses/contacts once a year. Frames are covered up to $120 every year with Plan C and every two years with Plan B. Co-payments are $10 for an exam and $25 for glasses with standard lenses in Plan B, and $20 for both in Plan C. Contact lenses and certain lenses for glasses are discounted in price but not included in the $25 co-pay.

AFLAC Insurance

We offer 4 individual supplemental insurance products through AFLAC: Life, Accident, Cancer, and Specified Health Event (includes heart, stroke, kidney failure and other conditions). Premium costs are paid by the employee, and rates vary according to age and family coverage chosen. This insurance pays cash directly to the employee or beneficiary regardless of health or other insurance coverage. Please consult the AFLAC representative (Cheryl Miller, 875-1961) for further information, as well as to enroll and determine your premium amount.

Cancer Plus 30 insurance

You can continue your current coverage by checking the appropriate box on the Section 125 form, or change coverage. However, we are not enrolling new employees in this plan. You may want to consider signing up for the AFLAC Cancer policy.

Rec-Fitness Center membership

For you, your spouse, and your children under 19 not in college (or if single, then a friend) can be included on your membership. No need to fill out a form during open enrollment unless you are becoming a new member or changing dependents. If you wish to cancel membership, please send an email to

Medical expense reimbursement account (FSA/Section 125)

Decide how much you wish to take out of your check tax-free for medical expenses you incur during the college year that are not covered by insurance. Employees are no longer able to use FSA/Section 125 funds for over-the-counter medications, except for Insulin and OTC medications and nutritional supplements that are prescribed by a medical practitioner. There is a limit of $2550 for medical expense reimbursement. For more information, see IRS Publication 502. Also, in choosing how much to place in your medical reimbursement account, you may want to consider the deductible of $1500/3000 and the 70% coverage after meeting the deductible. Note that the law has changed and you may carry over up to $500 per year of unused FSA/Section 125 medical expense funds.

Childcare expense reimbursement account (FSA/Section 125)

Same as above, except it applies to childcare expenses for children under age 13 so you can work.

Both of the “FSA/Section 125″ reimbursement account benefits have the tax-free deduction advantage mentioned above. However, in the case of the childcare deduction, what you haven’t used for eligible expenses occurring during the college year is forfeited.

NOTE: For those participating in either medical or childcare reimbursement accounts, you will need either use the debit card issued to you at the beginning of the plan year or file claim forms with Harrison Group along with the explanation of benefit forms you receive from Highmark PPO or the receipt from your childcare provider. Claim forms are found here.

Sign-up instructionsWe strongly encourage you to complete the Annual Open Enrollment form at the Benefits Fair on April 20th. On this form you need to list your health, dental and supplemental insurance coverage choices. There will also be a separate FSA/Section 125 enrollment form from the Harrison Group. Please complete these forms even if you are not having any money withheld from your paycheck. Please consult the AFLAC representative (Cheryl Miller, 875-1961) to enroll and determine your premium amount.

You need to complete a new application for health, dental, AFLAC and Vision Service Plan insurance only if you are adding or changing coverage.

If you do not fill out an Annual Open Enrollment form for 2015-16, we will continue the same coverage you elected in 2014-15 on medical, dental, and supplemental insurances.  If you do not fill out an FSA/Section 125 form, we will also assume you do NOT want to participate in the medical or childcare reimbursement accounts in 2015-16.

If you are enrolling in dental, health or any supplemental insurance for the first time or changing coverage, you must complete new enrollment forms. Completing the open enrollment form alone will not change your coverage. The health insurance form is available at Dental and the other insurance applications will be available at the Benefits Fair or from the HR office.

Return all forms to Vickie Miller through campus mail or drop them off at Westlawn 103 no later than Friday, May 15th. Call Vickie Miller or Norm Bakhit with any questions.


TIAA-CREF and Everence Financial representatives will be available at the Benefits Fair or you may contact them directly anytime about enrolling. Changing the amount withheld from your paycheck for your retirement fund can be done anytime during the year so is not part of the open window/enrollment period. Please request a salary reduction agreement from the HR office.

As always, contact Vickie Miller at, 535-6111, or Norm Bakhit,, 535-7507, for more information.