Annual Open Enrollment
October 24th – November 18th
All changes and enrollments during this period will become effective January 1, 2017.
Forms must be received in the Human Resources Benefits Office
on or by November 18th
HEALTH, DENTAL, and VISION COVERAGES: Now is the time for benefit-eligible employees
to enroll or make desired changes to their current insurance plans. Eligible dependents can be
added (with required documentation) by completing the Employee Application-Change form .
If you make no changes to your insurance plan(s), your current insurance plan selections
will rollover into 2017.
WAIVING COVERAGE: Benefit-eligible employees that elect to waive Health, Dental, and/or
Vision coverage for 2017 must complete Section C of the Employee Application-Change form
indicating the plan(s) you are waiving coverage for in 2017.
COORDINATION OF BENEFITS: All employees with a spouse or same-sex domestic partner
with primary coverage under the University’s plan will need to recertify their coverage. Spouse
certification form. Re-certification is not necessary if your spouse or same-sex domestic
partner also works at YSU and has secondary coverage on the University’s plan.
FLEX SAVE: Flexible Savings accounts provide an opportunity to reduce your taxes and
increase your take-home pay. You must re-enroll for Medical and Dependent Daycare
accounts each plan year. FLEXSAVE enrollment form
IRS mandates the maximum contribution cannot exceed $2,550 for medical health care and
$5,000 for dependent child care or elder care. FlexSave accounts can be used for out of pocket
expenses related to health care services that may not be covered by your health plan and
dependent care or elder care.
To learn more about the Flexible Savings Plan or to enroll in the Flex Save program,
representatives will be available to assist you as noted below:

Kilcawley – Jones Room – Thursday, October 27th, @ 11:30 am and 2 pm

Kilcawley – Presidents Suite – Monday, October 31st, @ 11:30 am and 2pm
VOLUNTARY LIFE INSURANCE: We will also be conducting a Voluntary Life Open
Enrollment from November 9- 18 for employees, spouses and children. This is a Guaranteed
Issue opportunity to purchase additional life insurance at specified amounts. SunLife Voluntary
coverage
SunLife representatives will be available from 9:00 a.m. to 3:30 p.m. to answer individual
questions and assist with enrollments.
SunLife Presentations at:

Kilcawley – Bresnahan 3 – Wednesday, November 9th @ 11am and 1:30pm

Kilcawley – Hynes Room – Tuesday, November 15th @ 11 am and 1:30pm
UPDATE YOUR BENEFICIARY: We highly recommend updating your beneficiary information
for both the employer paid life insurance and if you are currently enrolled in Voluntary Life
insurance. Life Beneficiary Form
THINGS TO CONSIDER FOR 2017 OPEN ENROLLMENT
Do I need to:
Link to Form
Make any changes to Medical/Rx, Dental
and/or Vision plans OR Waive insurance
Complete COB for spouse and domestic
partners with primary coverage
Enroll in Flex Save
Employee Application-Change form
Enroll in Voluntary Life Insurance
SunLife Voluntary coverage
Update beneficiaries on any life policies
(Employer paid and/or voluntary)
Life Beneficiary Form
Spouse certification form
FLEXSAVE enrollment form
QUESTIONS?: Contact Marcie Patton, at [email protected]
or Ext. 1322 or
Linda Mazzocco, at [email protected]
or Ext. 3748
Forms must be received in the Human Resources Benefits Office in Tod Hall, Room 312
on or by November 18th