Our enrollment period is November 01 - December 15, 2017. On ourOpen Enrollment homepagewe have a Benefits Interest form. After completing this form, we will contact you to collect additional information - you must provide the following information for all enrolling workers, dependents, and partners: full legal name, address, gender, and SSN or Taxpayer ID number.
All enrollment information should be sent firstname.lastname@example.org. Once we receive an enrollment form we will send your workplace a contract to be signed and returned.