There are three (3) items on this webpage; please scroll to view all items.
1) Open enrollment presentation
2) Voluntary life rate sheet
3) Health, dental, vision, life, short-term disability, and long-term disability insurance enrollment form (MUST BE COMPLETED)
Open Enrollment Presentation
Voluntary Life Rate Sheet
Use this spreadsheet to determine the cost per pay period for voluntary life, voluntary spouse life, and voluntary child life insurance.
Enrollment form for Health, Dental, Vision, Life, Short-Term Disability, and Long-Term Disability insurance
- ALL fillable fields on form MUST be completed.
- Please see enrollment instructions email for form password.
- Completing the form is a two-step process.
- When you are ready to submit the form, fill out the signature line. A blue "Click to Sign" button will appear in the lower right corner.
- When you click on the blue button, you will be directed to enter your email address.
- You will receive a confirmation email from Adobe Sign (email@example.com) with the subject line, "Please confirm your signature on CDS Open Enrollment 2019."
- Click on the link in the email to confirm your email address.
- You will receive a final copy of your enrollment form when you have confirmed your email address.
- Your enrollment form submission is not complete until you have received the second confirmation email.
- You may refresh this webpage to complete the FSA enrollment form.