Open enrollment period for 2022:  Nov. 5 - 19, 2021.

To make changes to your benefits for 2022, complete the following steps no later than 5 p.m. on Friday, Nov. 19, 2021:

  • Step B. Review your current benefit elections on myPugetSound in HR Self Service.
  • Step C. Review vendor-specific information to help with decision making.
    • For information on flexible spending accounts, view the FSA Employee Guide provided by Wex (Formerly Discovery Benefits)​​​​​
    • For information regarding voluntary life and AD&D insurance, view the Benefits At-A-Glance from Lincoln Financial Group
    • To see the difference between base and buy-up vision benefits, view the Benefits Summary from VSP
  • Step D. Complete the enrollment form(s) available through the links below.  The open enrollment/change form is an electronic form that is completed and submitted online.  All benefits-eligible faculty and staff are asked to complete an open enrollment/change form regardless if they are currently electing university benefits or if they are making changes.  Please note that no paper enrollment forms will be accepted.
    • 2022 Open Enrollment/Change Form (operates much like a survey in that you will respond to questions about your benefit elections and dependents) - You must be logged into your Puget Sound google account prior to clicking on the link. Once the form is complete and you have clicked “submit”, you will receive an e-mail confirmation including a copy of your responses.  You can change your medical, dental or vision enrollment, supplemental life and/or AD&D coverage, or participation in the healthcare or dependent care flexible spending account
    • 2022 Benefits Election Worksheet (use this worksheet to calculate your payroll deductions - includes rates and instructions for calculating supplemental life and AD&D premiums)
    • Affidavit of Marriage or Domestic Partnership Form (required if you are enrolling your spouse, domestic partner and/or domestic partner's child for a benefit for the first time) - Email to
    • Lincoln Financial Beneficiary Designation Form (recommended if Life/AD&D beneficiaries haven't been updated recently) - Email to