Anthem Enrollment Form

Open enrollment for health insurance will be from May 1, 2018 – May 28, 2018. This is the time to enroll, to make changes to dependents (adding or removing), or to change plans from Choice Plus to Standard.

Please note, these enrollment changes go into effect on September 1st for teachers and July 1st for everyone else.

It is extremely important that you make any and all changes during open enrollment, as there are limited changes that can be made outside of these dates. The only time you can make changes outside of open enrollment is when there is a “Qualifying Event”. Examples of a qualifying event would be:

• Marriage

• Divorce

• Birth/Adoption

Spouse/Dependent terminates employment (you only have 60 days from the date of the qualifying event to submit the application – coverage to be effective first of the month following Anthem’s receipt of the application.) For example, if your spouse/dependent loses health coverage on 09/30/2017, you would need to contact me and fill out the application for me to submit to Anthem before 11/30/2017 so the change would be effective 10/01/2017 and you would be responsible for the back dated premiums.

Please contact Josette Duguay at 369-5560 ext. 8219 or jduguay@rsu10.org if you have any questions.

Open enrollment for dental insurance will be from May 1, 2018 – May 25, 2018. This is the time to enroll, cancel, or to make changes to dependents (adding or removing). Changes to dental insurance goes into effect July 1st for all bargaining agreements.

Open enrollment for VSP insurance will be from May 1, 2018 – May 25, 2018. This is the time to enroll, cancel, or to make changes to dependents (adding or removing). Changes to vision insurance goes into effect July 1st for all bargaining agreements.