2021 Open Enrollment

2021 Forms and Books for Download

JJE / PWE Open Enrollment Materials

2021 Benefit Book Interactive Version (same as ESG Guide) This PDF displays in a two-page spread like a book - updated 10/15/2020

2021 Benefit Book Print Version  (same as ESG Guide)File for printing single pages on letter size paper, 8 1/2" x 11" - updated 10/15/2020

ESG ONLY Spouse Medical Plan Eligibility Certification Form 2021_2 pages

Video link to OE Presentation   JJE / ESG Monthly Rates

Video link to OE Presentation   PWE / JJE / ESG Weekly Rates

IBEW Open Enrollment Materials

2021 IBEW Open Enrollment One Page Guide - 2 sides to be printed locally - updated 10/15/2020

2021 IBEW Benefit Book Interactive Version This PDF displays in a two-page spread like a book - updated 10/16/2020

2021 IBEW Benefit Book Print Version File for printing single pages on letter size paper, 8 1/2" x 11" - updated 10/16/2020

2021 Declaration_of_Domestic_Partnership

 IBEW ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form 2021_2 pages

Video link to OE Presentation

SSG Open Enrollment Materials

2021 SSG Open Enrollment One Page Guide  - 2 sides to be printed locally - updated 10/15/2020

2021 Benefit Book Interactive Version  This PDF displays in a two-page spread like a book - updated 10/15/2020 Note: this is the same as ESG book, it does not include "Domestic partner" language

2021 Benefit Book Print Version  File for printing single pages on letter size paper, 8 1/2" x 11" - updated 10/15/2020 Note: this is the same as ESG book, it does not include "Domestic partner" language

2021 Declaration_of_Domestic_Partnership

 SSG ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form 2021_2 pages

Video link to OE Presentation

"ESG" Open Enrollment Materials for Corporate, Elgin, Vactor, Guzzler, Jetstream: No DP

For EEs paid semi-monthly and weekly, monthly benefit rates are quoted in book

2021 ESG Open Enrollment One Page Guide 2 sides to be printed locally - updated 10/15/2020

2021 Benefit Book Interactive Version  This PDF displays in a two-page spread like a book - updated 10/15/2020

2021 Benefit Book Print Version  File for printing single pages on letter size paper, 8 1/2" x 11" - updated 10/15/2020

ESG ONLY Spouse Medical Plan Eligibility Certification Form 2021_2 pages

Video link to OE Presentation

OE Presentation Slides Only This PDF is to view or print 10/22/2020

TBEI Open Enrollment Materials

 

TBEI ONLY Spouse Medical Plan Eligibility Certification Form 2021_2 pages

MRL/HighMark Open Enrollment Materials

2021 MRL Hourly Open Enrollment One Page Guide - 2 sides to be printed locally - updated 10/23/2020

2021 MRL Salaried Open Enrollment One Page Guide - 2 sides to be printed locally - updated 10/23/2020

2021 Benefit Book Interactive Version - This PDF displays in a two-page spread like a book - Coming soon

2021 Benefit Book Print Version - Thisa PDF file is for printing single pages on letter size paper, 8 1/2" x 11" - Coming soon

Video link to MRL OE Presentation   - updated 10/26/2020 no medical rates in presentation, see One Page Guides for rates

MRL OE Presentation Slides Only- This PDF contains the slides in the video above, no rates, and is to view or print 10/23/2020

MRL/HighMark ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form No Surcharge 2021 2 pages  10-26-2020

 FS Wellness Program Materials

 Physician Screening Form 2019/2020 Wellness Program

 Spouse/Domestic Partner Eligibility Certification Forms

 SSG ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form 2020_2 pages

 IBEW ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form 2020_2 pages

 ESG ONLY Spouse Medical Plan Eligibility Certification Form 2020_2 pages

 TBEI ONLY Spouse Medical Plan Eligibility Certification Form 2020_2 pages

 MRL/HighMark ONLY Spouse Domestic Partner Medical Plan Eligibility Certification Form No Surcharge 2021 2 pages  10-26- 2020

DNU Dependent_Eligibility_Documentation_Requirements

2019 CVS Caremark Formulary   Coming soon

COBRA Open Enrollment   Currently not available

COBRA for IBEW  Open Enrollment     Currently not available

Tips for Reducing Rx Costs

 

 

Delta Dental About the Enhanced Benefit Program

Delta Finding a Network Dentist

Delta Member Connections

SPP 7.3 for 2020 Sexual Harassment Training

Form W-9 (Rev. October 2018) - IRS

 

 

How To Instructions for Download & Onboarding New Hires

Pay Statements: Changing Your Preference for Paper or Electronic Access

W-2 Wage Statements: Changing Your Preference for Paper or Electronic Access

UltiPro Access Instructions for New Hires

Kronos Log-In Instructions

Live pages/graphics for linking to Messaging in UltiPro

2021 HSA Medical Plan Comparison Chart for Semi-Monthly Open Enrollment Session