2017-2018 Academic Year
Annual Open Enrollment Forms
Due Date: Monday, May 15, 2017
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
- choose which plan(s) in which you wish to enroll.
Important Dates to Remember
- Monday, April 17 – Monday, May 15: Open enrollment period
- Monday, April 24: 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.
- Monday, May 15: the last day to submit your Open Enrollment forms and any insurance application forms to Human Resources.
All forms must be completed and submitted to Human Resources by Monday, May 15. 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.
You may do all your sign-ups at the Benefits Fair Monday, April 24th, from 10:00 a.m.-noon. and 1:15-3:30 p.m. in the College Church Fellowship Hall.
The Benefits Fair on April 24th will feature representatives from 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 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.
The following benefits are involved in Open Enrollment:
Employee premiums will depend on employee participation in the Wellness Program. 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 health insurance rates have not changed for the 2017-2018 academic year. Goshen College will continue to pay the full employee premium as well as half of the premium for dependents of full-time employees.
*Contingent on meeting the wellness goal.
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).
The dental insurance rates have not changed for the 2017-2018 academic year. Employees pay the full cost of these premiums.
|Employee + 1 Dependent||$48.40|
The vision insurance rates have not changed for the 2017-2018 academic year. Employees pay the full cost of these premiums.
|Employee + Spouse||$15.35|
|Employee + Dependents||$16.16|
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 email@example.com.
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 unless prescribed by a medical practitioner. There is a limit of $2,550 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 $1,500/3,000 and the 70% coverage after meeting the deductible. You may carry over up to $500 per year of unused FSA/Section 125 medical expense funds.
Childcare Expense Reimbursement Account (FSA/Section 125)
Decide how much you wish to take out of your check tax-free for childcare expenses for children under age 13 so you can work. There is a limit of $4,992 for childcare expense reimbursement. There are no carry over of unused FSA/Section 125 childcare expense funds. 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.
We strongly encourage you to complete the Annual Open Enrollment form at the Benefits Fair on April 24th. On this form you need to list your health, dental, vision, and supplemental insurance coverage choices. There will also be a separate FSA/Section 125 enrollment form from the Harrison Group.
If you do not fill out an Annual Open Enrollment form for 2017-2018, we will continue the same coverage you elected in 2016-2017 on medical, dental, and vision 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 2017-2018.
If you are enrolling in dental, health, or vision 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. Insurance applications will be available at the Benefits Fair or from the HR office.
Return all forms to Human Resources through campus mail or drop them off at Westlawn 103 no later than Monday, May 15. Call Human Resources 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 firstname.lastname@example.org for more information.