Open Enrollment

Open Enrollment 2017
November 01, 2016 - November 11, 2016


Letter from Human Resources

Medical, Dental, and Vision Rates

2017 Medical Plans Comparison

Open Enrollment Change Form for New Enrollments or Plan Changes

Click here to view the Open Enrollment Guide.  This guide includes everything you need to know for Open Enrollment.  It includes all benefit summaries, rates, information on adding dependents and more. 

This year, only new enrollments or plan changes must be submitted.  If you are currently enrolled in the Medical PPO70 plan, you must enroll in a new plan for 2016 using the online Open Enrollment Change Form.  If you would like to enroll in a Flexible Spending Account (Medical or Depedent Care) or Health Savings Account for 2016, you must submit an enrollment form to Human Resources by Friday November 13th. 

Flexible Spending Account Enrollment Form Health Savings Account (HSA Bank) Enrollment Form.

*Persons who do not have access to the internet or who have trouble using the online form should contact the HR Office at (972) 721-5382.  Paper enrollment forms and materials are available upon request.


 

Open Enrollment Form

Enrollment form will be available beginning Monday, November 3.


Adding Dependents Employees must include dependent documentation when adding eligible family members. 

Dependent Documentation

Dependent Certification Form

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