2021 Open Enrollment
September 15 – October 31, 2020
Digital Form Submission
NOTE: Only elections/changes for The Standard Dental or Superior Vision may be submitted through this form. If you would like to elect for LegalShield/IDShield, you must call the call center at: 833-444-5220.
Steps to Submit:
- Choose which benefit(s) you’d like to enroll or change below.
- Fill out the form that appears.
- Once finished, you’ll be presented with a copy to download for your reference, you’ll also receive an email confirmation.
- That’s it! Once filled out it has been recieved for processing.