​PLEASE REVIEW AND SUBMIT APPLICATIONS to Elizabeth or Ben

​Benefit Summaries	​Bi-Weekly Rate Tables
BASIC LIFE	($15,000 Policy for all employees. Provided by imperial)
Voluntary Life & AD&D  For the Voluntary Life Insurance, anyone who either waived VTL initially or is enrolled now can add/increase two increments during this enrollment period. The highlighted Guaranteed Issue amounts only apply to anyone who is enrolling during their initial, new hire enrollment.  ​	​(additional coverage to Group Life) rate_table_-_voluntary_life.pdf
Voluntary Long-Term Disability (LTD)	​rate_table_-_voluntary_ltd.pdf
Voluntary Short-Term Disability (STD)	​rate_table_-_voluntary_std.pdf
Voluntary Dental	​rate_table_-_voluntary_vision___dental.pdf​
Voluntary Vision	​rate_table_-_voluntary_vision___dental.pdf

APPLICATION 

Application for new enrollees.

CHANGE FORM

Change form is for anyone currently enrolled that wishes to make changes (add/remove dependent, enroll in new coverage, cancel current coverage, etc)

​Statement of Health

​ (also known as Evidence of Insurability)

This form is needed for anyone electing STD and LTD outside of their initial, new hire enrollment

OPEN ENROLLMENT VIEDO