HDHP Switch Form (going from Traditional to High Deductible)
Employees interested in switching to the University's High Deductible Health Plan medical option should complete the above form and return it to Human Resources. When you turn in the switch form, you will be given a Health Savings Account packet with information on how to create your HSA account.
Traditional Switch Form (going from High Deductible to Traditional)
Employees interested in switching to the University's Traditional Health Plan medical medical option should complete the above form and return it to Human Resources. When you turn in this switch form, you will be given a traditional plan summary document, premiums required for this plan, and information about Flexible Spending Accounts.
Employees interested in adding uncovered dependents to their health insurance OR want to add/drop their current medical, dental, and/or vision reimbursement coverage should complete the above form and return it to Human Resources.
Flexible Spending for Health Care Expenses Only
Flexible Spending for Health Care AND Dependent Care Expenses
Employees who remain on the Traditional medical insurance plan can add a flexible spending account for both health care expense reimbursement and dependent care expense reimbursement. The first above form is for those only wanting flexible spending for health care reimbursement; the second above form is for those wanting flexible spending for both health care expenses AND dependent care expenses. There is a $1.50 per pay period administrative fee to participate in flexible spending and an additional $0.75 per pay period fee if you opt for the health care reimbursement debit card.
Flexible Spending for Dependent Care Expenses
Employees who switch to the High Deductible medical insurance plan can add a flexible spending account only for dependent care expense reimbursement. Please complete the above form if you are interested in this benefit. There is a $1.50 per pay period administrative fee to participate in this type of flexible spending account.
Employees interested in making changes to their current life insurance coverage should complete the above change form and return it to Human Resources. Supplemental Life Insurance rates are posted online at http://suu.edu/ad/hr/benefits.html. Any employee with basic life coverage may add new or additional voluntary employee supplemental life insurance up to $50,000 without completing medical underwriting.
Employees interested in adding long-term disability coverage (during their first two years of employment) should complete the above change form and return it to Human Resources.