DEADLINE IS JANUARY 12, 2023

STEP 1

Review the following documents:

• Click Here For BCBS PPO Gold Plan
• Click Here for BCBS HSA Silver Plan
• Click Here for Medical Plan Comparison
• Click Here for Vision Plan
• Click Here for Dental Plan with Orthodontist
• Click Here for Dental Plan without Orthodontist

STEP 2

Complete (in its entirety) the employee benefit application.

Click Here for Medical & Dental Application

STEP 3

Email your completed application to:

[email protected]

Medical Plan Biweekly Premiums

Amount deducted per pay period

Dental & Vision Plan Monthly Premiums

**The rates listed are not final. Actual and final rates will be calculated after enrollment and sign ups are completed. Once a plan is selected, you will be unable to unenroll.**



If you have specific plan questions, please email (ONLY) to:

[email protected]