• Review Benefit Plan options to select your coverage:
  • Medical: PPOA, PPOB, or HDHP
  • Dental: PPO
  • Vision: VSP

• Review plan options to determine coverage or refer to the appropriate Benefits Guide.
• Some Employee Life plan options with higher coverage amounts may require additional information to determine enrollment eligibility. Please refer to the eligibility requirements located in the Benefits Guide. 
• If you elect Life coverage with a higher coverage amount, request the appropriate form to provide evidence of insurability before submitting your elections. If evidence of insurability is not received with your benefit elections, the highest allowable amount will be selected for you.
• Spouse Life coverage cannot exceed the amount of employee Life coverage. Evidence of insurability may be required if you newly enroll or increase coverage over $50,000. Request the appropriate form to provide evidence of insurability. 
• Circle the corresponding plan option and coverage level for each benefit.

• Review plan options to select your coverage:
  • Health Care FSA or Limited Purpose FSA
  • Dependent Care FSA 
  • Health Savings Account (for HDHP).
• Determine the total annual amount you would like to contribute to each FSA. If you know the amount you would like taken out of each paycheck, multiply that by the number of paychecks you will receive for the remainder of the year. (See the payroll calendar received at new hire orientation).
• Circle the corresponding plan option and write in the total annual amount you would like to contribute to each account selected.
• Reminder: These elections must be renewed during Open Enrollment to continue contributions for the following year, otherwise, they will cease at the end of the current year.

• Review the Benefits Guide specific to your employee classification for additional information about the coverage available to you and how to determine which dependents may be eligible for coverage.
• Determine who will be covered under each plan: Employee Only, Employee & Spouse, Employee & Child(ren), or Employee & Family.
• Gather required documentation for those covered under any plan:
  • Enrolling spouse: Copies of your marriage license and your spouse’s Social Security card.
  • Enrolling eligible child(ren): Copies of your dependents’ birth certificates, and Social Security cards. 
• Circle the corresponding plan option and coverage level for each benefit. (Your Benefits Enrollment Form was provided to you in your Welcome email with New Hire Orientation information).
• Determine if you need to inform UNS of any prior contributions made to a 401(k) this calendar year to avoid tax penalties. Complete the 401(k) prior contribution form, if necessary.
• Ensure your eligible elected benefits can be passed on to a designated beneficiary by completing the beneficiary form. Note: Determine if your form must be notarized based on who has been designated (additional information is located at the bottom of the form).

Review plan options to determine coverage or refer to the appropriate Benefits Guide.

• Accident & Critical Illness
• Life & Long-Term Care
• Pet Insurance
•  

• Confirm all benefit elections have been made and that the form is signed and dated.
• If you completed the beneficiary form, confirm that it is signed and dated on the page 2 participant signature line.
• If you are not electing a benefit offered, please circle “waive” in that section to avoid default enrollment in coverage.
• Ensure all required documentation based on plan elections and coverage has been gathered.
• Upload your required documentation and forms to this secure link: Benefits Secure Upload.
  • TIP: Use a mobile phone to scan and upload documents.