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OPEN ENROLLMENT – 2017

Open enrollment is an opportunity for employees to add, drop, or make changes to their existing company sponsored insurance coverage for the following benefits:

  • Blue Cross & Blue Shield Health Insurance
  • Blue Cross & Blue Shield Dental Insurance
  • Lifestyle Health Insurance
  • CVS Caremark Prescription Insurance
  • Benefit Connection Gap Insurance (aka SIS Insurance)
  • Principal Dental Insurance
  • Principal Vision Insurance
  • Principal Voluntary Life Insurance*
  • Principal Voluntary Life & AD&D Insurance*
  • Principal Critical Illness*
  • Principal Voluntary Short-Term & Long-Term Disability*
  • TASC Flexible Spending Accounts (Medical and Dependent Care)

*Subject to carrier approval; health statement questionnaire required

Please refer to your open enrollment announcement for applicable benefits. Below are the documents and forms required to enroll in, or make changes, during open enrollment:

DOCUMENTS:

BFTS – BCBS of AL Median Modified Health Benefits Summary 10.2016
BFTS – Benefit Connection Gap Insurance Benefits Summary 10.2016
BFTS – BCBS of AL Median Modified Health Summary of Benefits Coverage (SBC) 10.1.17
BFTS – BCBS of AL Dental Insurance Booklet 51104 10.2016
BFTS – BCBS of AL Dental Insurance Summary 51104 10.2016
BFTS – BCBS of AL Median Modified Health SBC Glossary of Terms
BFTS – Benefit Connection Gap Summary Plan Document (SPD) 10.2016
BFTS – CVS Digital Features CVS Caremark & Mobile
BFTS – CVS Tyonek Group Summary 10.2017
BFTS – Principal Vision Insurance Discounts & Services Brochure 10.2016
BFTS – Lifestyle Healthy 100 SBC Glossary of Terms
BFTS – Lifestyle Healthy 100 Summary of Benefits 10.2017
BFTS – TASC Advantages of FSA 10.2017
BFTS – TASC Flexible Spending Account (FSA) Mobile Application Brochure 10.2017
BFTS – Principal Critical Illness Booklet 10.2016
BFTS – Principal Critical Illness Brochure 10.2016
BFTS – Principal Dental Insurance Policy 10.2016
BFTS – Principal Dental Insurance Summary 10.2016
BFTS – Principal Long Term Disability Summary (Voluntary & SCA Mandatory Sites)
BFTS – Principal Short Term Disability Summary (Voluntary & SCA Mandatory Sites)
BFTS – Principal Vision Insurance Summary 10.2016
BFTS – TASC Flexible Spending Account (FSA) Dependent Care Qualifications Brochure 10.16
BFTS – TASC Flexible Spending Account (FSA) Eligible Expenses Brochure 10.2017
BFTS – TASC Flexible Spending Account (FSA) Employee Education Brochure 10.2017

FORMS:

401K – TNC Beneficiary Designation Form
401K – TNC Enrollment Form 2017
401K – TSG Beneficiary Designation Form
401K – TSG Enrollment Form_2017
BFTS – AG&D TASC FSA Enrollment Form
BFTS – BCBS of AL Health Insurance Enrollment Form (MEDICAL only 3 TIER)
BFTS – BCBS of AL 3 Tier MED_DEN Enrollment Form
BFTS – Benefit Connection Claim Form
BFTS – Benefit Connection Employee GAP Insurance Enrollment Form
BFTS – Lifestyle Health Enrollment Form
BFTS – Principal Beneficiary Change Form
BFTS – Principal Benefit Election Change Form
BFTS – Principal Statement of Health Form
BFTS – Principal Vision Claim Form
BFTS – TCG TASC FSA Enrollment Form
BFTS – TMG TASC FSA Enrollment Form
BFTS – TNC TASC FSA Enrollment Form
BFTS – TSG TASC FSA Enrollment Form
HR – Change of Employee Information Form
HR – Direct Deposit Form