Should you need help at any time during the open enrollment process, please contact askHR by phone at ext. 2000 or by email askHR@baylor.edu.

Open enrollment is your annual opportunity to make benefit changes to your current insurance plans and/or enroll/continue with your FSA for the following calendar year. Elections/changes during open enrollment are effective January 1. Enrollment or cancellation of participation in group medical, dental, cancer, intensive care, recovery plus, or accident insurance products may only be completed during the open enrollment period. Eligible faculty/staff who reject or drop coverage may not enroll until the next open enrollment period unless qualified based on a change in Life Events.

Completed open enrollment forms may be mailed to:

Human Resources
One Bear Place #97053
Waco, TX 76798-7053
OR
dropped off at Robinson Tower, Suite 200
OR
faxed to 254.710.3819
OR
some forms allow for electronic signature and submission and may be scanned/emailed to askHR@baylor.edu.

PLEASE RETAIN A COPY OF ALL FORMS SUBMITTED FOR YOUR RECORDS.

2013 Medical and Dental Plan Changes

Flexible Spending Accounts

Participation/continuation in flexible spending accounts requires annual enrollment.

*For 2013, the maximum election for the Unreimbursed Medical FSA will change to $2,500.00.

• Flexible Spending Account Enrollment Form

• take care FSA Plan Information

• Convenience of the take care Card

BCBS Medical Plan and CVS/Caremark Prescription Plan

To add or cancel the group medical plan (BCBS/CVS CAREMARK) or;
To add or cancel dependents to or from your group medical plan (BCBS/CVS Caremark):

• Benefits Enrollment Application/Change Form

◊ Enrollment in the medical plan
◊ Adding dependent to your medical plan
◊ Life Insurance beneficiary would not be added to this form.
◊ All other sections would be completed if applicable.
◊ Adding medical coverage will add a deduction to your payroll check.
◊ Adding a dependent may also increase your deduction to your payroll check.

•  Employee Premiums

Dental Plan

To add/cancel your dental plan or to change your dental provider:

• Benefits Enrollment Application/Change Form

• DR Premiums/Plan
• QCD of America
• QCD Premium Schedule

♦ Adding dependents to your dental plan may add a deduction to your payroll check.

Supplemental Insurances

To cancel Supplemental Insurance plans:

• Cancellation of Supplemental Insurance Form

To add Supplemental Insurance plans:

•  Accidental Death & Dismemberment

◊ Enrollment Form

♦ Complete section for Voluntary Accident Insurance (VAI).

♦ Adding Accidental Death & Dismemberment (AD&D) will add a deduction to your payroll check.

•  AFLAC Insurance Plans

◊ Baylor AFLAC agents

♦ Enrollment applications are processed with an AFLAC agent.

•  Supplemental Term Life

◊ Enrollment Form
◊ Evidence of Insurability Form

♦ Forms are forwarded to Human Resources and are subject to Dearborn National's underwriting department's approval. Enrollment in the supplemental term life benefit can also be requested during the calendar year.

•  UNUM Long Term Care

◊ Enrollment Form
◊ Evidence of Insurability Form
◊ Acknowledgement of Disclosure of Rating Practices (1149-02)
◊ Potential Rate Increase Disclosure Form (1141-02)

◊ Forms are forwarded to Human Resources and are subject to UNUM's underwriting department's approval. Enrollment in the UNUM Long Term Care benefit can also be requested during the calendar year.