Open Enrollment ~ 2023/2024
All changes
are due to the SAU
no later than,
Friday, May 26th
~ ~ ~ ~ ~
* Enrollment Forms can be found towards the bottom of this page *
| Health Insurance - SchoolCare (CIGNA) | July 1st - June 30th |
| Dental Insurance - SchoolCare (CIGNA) | July 1st - June 30th |
| Vision Plan (VSP) - SchoolCare (CIGNA) | July 1st - June 30th |
| Flex Spending Accounts - Medical & Dependent (VOYA) | July 1st - June 30th |
| 403(B) - Individual Retirement Savings Plan | Year Round |
What is Open Enrollment?
Open enrollment gives you a once a year opportunity to:
- Enroll in Medical, Dental, Vision and/or Flex Spending Accounts
- Change plans
- Join a plan if you had other coverage and/or did not join when you were first eligible
- Add eligible dependents that did not join when they were first eligible
What You Need to Do:
- If you would like to make a change, please fill out the appropriate form found below.
- You need to complete a new flexible spending account form on an annual basis if you wish to participate. This benefit is not automatically renewed!
No Changes Now?
- Just remember to report all status changes in a timely manner (within 30 days of a status change). Status changes include: birth, adoption, marriage, divorce, legal separation, death or address change.
- If you are NOT making changes to medical, dental and/or vision you do NOT need to complete an enrollment form.
Choice Fund activation deadline:
- If you are enrolled in the Yellow Plan with Choice Fund, don't forget to complete your Health Assessment to activate Choice Fund. This can be completed from June 1st - July 31st.
Please feel free to contact Christie Menard with any questions via email or (603) 526-9165
__________________________________________________________________________________
ENROLLMENT FORMS
- Flex Spending Enrollment Form - 20 Deductions for Teachers, Technology, Administration, Administrative Assistants, Facilities, SAU Staff
- Flex Spending Enrollment Form - 18 Deductions for Para-Educators and Interventionists
- Medical/Dental/Vision Enrollment or Change Form
- Salary Reduction Form 403(b)- OMNI
MEDICAL PLAN INFORMATION
- Yellow Plan (with or without Choice Fund) Summary Chart - Quick View
- Orange Plan Summary Chart - Quick View
- Yellow Choice Fund SBC
- Yellow Plan SBC
- Orange Plan SBC
MEDICAL PLAN VIDEOS
Yellow Plan With Choice Fund Overview:
https://www.youtube.com/watch?v=44bDhHC6LsQ&t=45s
Yellow Plan Overview:
https://www.youtube.com/watch?v=m1XKm7usb8s
Orange Plan Overview:
https://www.youtube.com/watch?v=5-fAB79zwGE
DENTAL PLAN INFORMATION
- Dental Core ($750) Teachers Only
- Dental High ($1,000) Teachers & Support Staff
- Summary Plan Description
VISION (Hardware Assistance)
FLEX SPENDING INFORMATION
MISCELLANEOUS
- CHIP Annual Notice
- School Care Open Enrollment Video - Good Stuff!