Open Enrollment
Oct 17 - Oct 28

All open enrollment forms are due back to Human Resources no later than FRIDAY OCTOBER 28, 2022.

If you have any questions, please contact Jessica Phelan at Jessica.Phelan@colchestersd.org,
or Lindsey Troescher at Lindsey.Troescher@colchestersd.org.

What is Open Enrollment:

Open Enrollment is the event that enables you to elect or make changes to your benefits. After this open enrollment period is completed, generally you will not be allowed to change your benefit elections or add dependents until the next year's open enrollment period, unless you have a qualified status change.

How to Enroll, Re-Enroll or Make Changes:

The first step is to review your current benefit elections. Are you planning on enrolling in a benefit for the first time or make a change to your existing medical or dental plans? Have you updated your life insurance beneficiaries? Did you want to participate in Section 125 – Flexible Spending Health (FSA) or Dependent Care (DCA) or Insurance Buyout this year?

• Medical and/or Dental – New enrollment, addition, cancellation or changing plans requires an enrollment-change form to be completed. If you are not making any changes, your current elections will carry over to next year.
• Medical Buyout – This is an annual election; you must fill this form out each year in order to participate. Remember to include a copy of your current medical insurance card.
• Section 125, Health and/or Dependent Care Flexible Spending Account (FSA/DCA) – This is an annual election; you must fill this form out each year in order to participate.
• Group Life Insurance – For beneficiary changes, complete a beneficiary change form. If you would like to add or change your coverage amount, please contact Jessica Phelan.

When to Enroll:

The open enrollment period runs from Oct 17 - Oct 28. The benefits you elect during open enrollment will be effective beginning on January 1, 2023. All forms should be returned to HR no later than Friday October 28, 2022.

Open Enrollment Information:

• Open Enrollment Health Insurance Info/FAQ

How to Contact Human Resources (HR):

Should you have any questions, please contact Jessica Phelan at 264-5980, Jessica.Phelan@colchestersd.org or Lindsey Troescher at 264-5976, Lindsey.Troescher@colchestersd.org.

The Forms:

All of the following forms are in Adobe Acrobat PDF format.

• Dental
  • Delta Dental Enrollment/Change Form
• Group Life Insurance
  • Life Insurance Beneficiary Designation Form
• Medical
  • Medical Enrollment/Change Form
  • Medical Buyout Form Annual Election
  • HRA Enrollment Form
  • HSA Enrollment Form
• Flexible Spending (FSA) Health & Dependent Care (DCA) Reimbursement
  • Flexible Spending Election Form

Plan Information and Documents:

• Dental
  • Outline of Coverage
  • HOW Summary of Enhanced Benefits
  • EyeMed Vision Discount
  • Benefit Lookup Flyer - Go Green
• HRA/HSA and Dependent & Health Care Flexible Spending
  • Healthy Dollars Plan Details
• Medical
  • VEHI-BCBS Medical Booklet