Benefits Open Enrollment

• Enroll in Health Saving Accounts (HSA) If enrolled or enrolling the High Deductible Plan
• Enroll/re-enroll for Flexible Spending Accounts (FSA)
• Change medical plan types (Traditional to PPO, etc.)
• Elect to add previously declined self and/or dependent dental coverage
• Switch premium deductions from post-tax to pre-tax or vice-versa
• If eligible, sign up for NCPERS life insurance (must be currently contributing to PERSI)
• Enroll or disenroll in medical and/or dental coverage

If you wish to keep your medical/dental plan as is, and you DO NOT wish to enroll/re-enroll in the flexible spending or health savings account, there is no need for you to complete and submit any forms.

If you DO wish to make changes to medical/dental benefits, and/or enroll/re-enroll in flexible spending or the Health Savings Account, please review the sections below for specific instructions to complete your forms.

All enrollment forms MUST be received by the ISU HR Office no later than 3 PM on Friday, May 16 to be accepted by the State Office of Group Insurance (OGI) for processing. See the section below “Options for Completing and Submitting Forms” for more information about how to complete and submit your benefits forms.

Many other changes, including beginning/changing supplemental retirement plan contributions and enrollment in voluntary term life insurance can occur at any point throughout the year.

To support our employees in completing these forms easily and securely, State OGI and ISU have developed enrollment forms that can be completed and submitted electronically through DocuSign.

To complete your open enrollment forms:

• Use the links above that correspond to the action(s) you want to complete.
• You will be prompted to enter your name (first and last), and ISU email address, then click “BEGIN SIGNING.” The form will automatically open in a DocuSign format. 
• Fill in the open fields on the screen to complete the form and make your selections. There are pop-up notes on some fields to help ensure information is entered correctly.
• When you are done and click the “FINISH” button, your document will automatically be time/date stamped and transmitted securely to the ISU HR Benefits Administrator. At this point, you may also download or print a copy of your completed form for your own records.
• NOTE: You may notice your downloaded document has an “In Progress” watermark visible on it after you click “FINISH.” However, there is no need for you to send any additional documentation to HR. You will receive an email notification and a final version of the submitted document after the HR Benefits Administrator has signed that it was reviewed and received.

If you have questions about your benefits, completing the forms, or the DocuSign process, contact our HR Benefits Coordinator, Janice Romero, for more information at (208) 282-3106 or email benefits@isu.edu.

All forms must be RECEIVED by the ISU HR Benefits Office no later than 3 p.m. on Friday, May 16 to be accepted by State OGI. There will be no exceptions to this deadline.

If you are unable to complete these forms electronically you can request paper form(s) by contacting Janice Romero at (208) 282-3106 or benefits@isu.edu, before Friday, May 09 to arrange to pick up or receive a mailed paper copy. Paper forms can be submitted via:

• Mail:  Office of Human Resources
        ATTN: Janice Romero
        921 S. 8th Avenue, Stop 8107
        Pocatello, ID 83209-8107
• Box: Use the file submission box below to upload your files 

Open Enrollment Flyer - Print to display in office