2004 TechSelect Open Enrollment

●     Forms are due in the Benefits office no later than 5:00 p.m. on Monday, November 24.

●     If you want your benefit choices effective for 2004 and you returned your form after Monday, November 24, but no later that 5:00 p.m. on Friday, December 12, you will be charged a late fee of $25.

●    NO CHANGES will be allowed after 5:00 p.m. on Friday, December 12.

IMPORTANT REMINDERS

●    If you want the same benefit package you selected for 2003, you must check the “No Changes” box on your form and return by the due date. If you do not return your form your benefit choices for 2003 will be canceled for 2004.

●    If you do not return your form by the due dates above you will automatically be placed into the Standard Plan and your flexible spending accounts will be canceled for 2004.

●     Those employees who have chosen the long-term disability insurance of 70%, please note the increase in rates.

●     THE FOLLOWING FORMS WILL HELP YOU IN YOUR CHOICES FOR 2004:

• Healthcare Worksheet 2004

• Bankers Life Voluntary Accidental Death and Dismemberment Cost

• Bankers Life and Casualty Company Group Accident Enrollment Form

• Benefits at a Glance
  • Premium Plan
  • Standard Plan
  • Deductible Plan
  • Dental & Vision Plan
  
  
  
  
  
  
  
  
  
  
  
  

   

  h:\ingrid\2003                                                                                                                                                                            11/05/03