Benefits Open Enrollment - COBRA

Health Care Benefits


Your health plan offerings for 2022 are based on your employee group.  Review your 2022 Open Enrollment guide below for more information about the plan(s) for which you are eligible. 

You do not need to take any action if you want to stay on your current health plan.  It will carry over to 2022, depending on your COBRA eligibility.

You may choose to change health plans during open enrollment (if you have two options) by completing the Health Insurance Enrollment and Change form. Coverage will be effective January 1, 2022.

You may also choose to add or drop dependents during open enrollment and the coverage will be effective January 1, 2022.

WHat forms do I need to complete?

To change your health care benefit election effective Jan. 1, 2022, complete the health insurance enrollment and change form.  If you choose the Healthy Blue Living HMO, you must also designate a Primary Care Physician (PCP) on this form.

To enroll a designated eligible individual effective Jan. 1, 2022, complete the designated eligible individual enrollment form and submit the supporting documentation.

Where do I send my completed forms?

Submit your completed health insurance enrollment and change form to Human Resources no later than 5 p.m. on Friday, Nov. 19, 2022.

If you are not able to print the enrollment forms, you may request a copy of the form(s) from Human Resources.

When will my changes take place?

Health care benefit elections are effective Jan. 1, 2022.

Medicare Part D and other important benefit notices?

View important Benefit Notices.

Are you or your dependent(s) eligible for prescription drug benefits under Medicare Part D due to age or disability? If so, please review the Medicare Part D Notice located under Benefits Notices above.

Additional Questions?

If you have additional questions about benefits open enrollment, please contact Human Resources.

The information outlined above is subject to legal documents that pertain to each benefit plan and policies, procedures, contracts, or collective bargaining agreements, which are controlling as to the availability and amount of benefits. This website is not a legal document.