2021 RESOURCES FOR OPEN ENROLLMENT

Open Enrollment 2021 Presentation

⇒  Action Required: 

• Open Enrollment Employee Form — 2021

• HRA – Application Form 2021  
  • Additional HRA Card Request
• HSA Application 2021 Form 
  • Certification of HSA Eligibility
• HSA Enrollment Form for Extra Employee Contribution 2021
• Health Flexible Spending Account (FSA) or Dependent Care (DC) Election Enrollment-Form

• Cash-in-Lieu – Health Insurance Buyout – FY2021

  If you are eligible for group health insurance and opt-out and have comparable, alternative group health insurance coverage, you are eligible to receive a cash-in-lieu payment.  The current cash-in-lieu rates can be found here:   Health Insurance Buyout for January 1, 2021 – December 31, 2021

Only for New Enrollments or Changes: 

• BCBS Enrollment Change Form 2020

• Delta Dental Enrollment or Change Form

• Domestic Partner Enrollment Form

⇒  Important Health Plan Information: 

Licensed Employees: 

• Licensed Employees –  Plan Comparison Grid of VEHI Health Plans 

• Health Insurance Rates — Licensed Employee 2021 Cost Comparison

• Health Insurance Rates — Licensed Employees 2022 Cost Comparison

Non-Licensed Employees: 

• Non-Licensed Employee – Plan Comparison Grid of VEHI Health Plans

• Health Insurance Rates Non -Licensed Employee 2021 Cost Comparison

• Health Insurance Rates Non- Licensed Employee 2022 Cost Comparison

⇒ Other Helpful Information:  

Open Enrollment Notice 2021

VEHI Website 

BC/BS VT Website 

VEHI Benefit Description Wrap Form 2021

VEHI Platinum and Gold Benefits Description Changes – July 2021

VEHI Gold and Silver CDHP Benefits Description Changes – July  2021

• • Stacked-vs-Aggregate-Deductible
  • 2021 Summary of Benefits  – Platinum 
  • 2021 Summary of Benefits – Gold
  • 2021 Summary of Benefits –  Gold CDHP 
  • 2021 Summary of Benefits – Silver CDHP
  • BC/BS & VEHI Helpful Packet

          Datapath Information:

• • FSA Enrollment Booklet
  • HSA Enrollment Book From Datapath -VT
  • HSA Fact Sheet – 2020
  • HSA Frequently Asked Questions – 2020
  •  HSA vs HRA – What is right for you
  •  Additional HRA and HSA Cards Request 
  • General Guidance HRA and HSA — June 2020 updated 11.12.2020

Employees’ Login of Individual HSA/HRA/FSA Accounts:    www.myrsc.com

Delta Dental Information:   

• • Delta Dental Booklet
  • Delta Dental Enrollment or Change Form  
  • Delta Dental PPO Plus Premier Claim Example

Summary Plan Description for the Cafeteria Plan