2013 Flexible Benefits Plan

ENROLLING IN THE FLEXIBLE BENEFITS PLAN

Staff members are eligible to enroll for these benefits when assigned to regular positions scheduled to work at least half-time (1,040 hours per year). Full-time faculty members, faculty members contracted to teach four units of course work or to meet an equivalent set of responsibilities during the academic year, and visiting faculty members contracted to teach three units of course work in one semester, are eligible for the flexible benefits plan.

Here’s what you need to do within 30 days from your date of hire (or date of appointment to an eligible position):

Step A.

Review the 2013 Election Guide for a detailed description of each of the benefits offered as part of this plan and to determine the benefits that are best suited to meet your and your family’s needs in 2013. You may choose from the following benefits:

• Choice of high deductible HRA medical plan or low deductible PPO medical plan (Premera Blue Cross) 
  • Please note that your child(ren) may qualify for coverage under the Washington Apple Health for Kids program. For more information about this program, please click here.
• Voluntary dental plan (Premera Blue Cross)
• Voluntary life insurance (Unum Life Insurance Company)
• Voluntary accidental death and dismemberment insurance (Unum Life Insurance Company)
• Voluntary short-term disability insurance (Unum Life Insurance Company)
• Voluntary Health care flexible spending account (ConnectYourCare)
• Voluntary Dependent care flexible spending account (ConnectYourCare)

Step B.

Complete the following forms as applicable.

• 2013 Benefits Election Worksheet (you may use this worksheet to gather and and calculate your desired benefit election costs; do not turn this worksheet in to Human Resources)
• 2013 Benefits Election and Enrollment Form (complete this form using the data entered on your worksheet)
• Affidavit of Marriage or Domestic Partnership Form (required if you are enrolling your spouse or domestic partner for a benefit for the first time)
• After-Tax Payroll Authorization Form (required if you are enrolling a domestic partner and/or domestic partner's children)
• Unum Beneficiary Designation Form (strongly encouraged for everyone)

Send your applicable form(s) to Human Resources. You can deliver in person to Howarth Hall 016, send through campus mail to CMB #1064, or scan and send via email to hr@pugetsound.edu, whichever is most convenient for you. Don't forget your signature on each document.

Need help?  Contact Human Resources for help at 253.879.3369 or hr@pugetsound.edu, or visit us at Howarth Hall 016 during our office hours (M-F, 8 a.m. to noon and 1 to 5 p.m.).

If you do not submit your completed forms to Human Resources within 30 days of your date of hire (or date of appointment to an eligible position), your 2013 benefit elections will automatically default to the high deductible HRA medical plan for yourself only with no other coverage. After your initial enrollment period is over, you will not have the opportunity to make changes to your benefits again until next year’s open enrollment (November 2013), unless you experience a qualifying status change (e.g., birth or adoption of a child, partner’s loss of employment).  

HIPAA Notice of Privacy Practices

The university's privacy notice may be found on pages 4-7 of the "Your Rights" section at the end of the 2013 Election Guide.