TO: Benefit Eligible Employees
FROM: Kate Elling, Benefits Coordinator
DATE: November 1, 2019
RE: Electronic Open Enrollment for 2020
Open Enrollment for School District sponsored insurance plans will begin now and continue through 4:00p.m. on Friday, November 15, 2019. This is your ONLY opportunity to make changes to your dental, life, and LTD insurance and enroll in the Flexible Spending Account (FSA) for 2020. As a reminder this Open Enrollment period does not include health insurance. A separate Open Enrollment will be held in May 2020 for health insurance changes to be effective July 1, 2020.
If you are not making any changes AND you do not want to enroll in a Flex Spending Account for 2020, you do not have to do anything.
The Open Enrollment process is AUTOMATED. All enrollment changes need to be made electronically through the secure Duluth Public School District’s website at https://www.isd709.org. Scroll to “STAFF RESOURCES” at the bottom of the page and then click on the “Open Enrollment” link. On this page, there are instructions and links on how to make changes and download additional miscellaneous forms.
NEW FOR 2020 – You DO NOT need to complete a Benny Card Enrollment form for your card to remain active for 2020. If you are a new participant electing to use the Benny Card, you can do so during this open enrollment process.
On the website you will find:
2020 Open Enrollment Information
Links to the on-line open enrollment forms
- Benny Card Enrollment Form 2020 (for new participants only)
- Delta Dental Change Form 2020
- Flex Spending (FSA) Election Form 2020
- Long Term Disability Insurance Tax Form 2020
- Flexible Spending Information
- 2020 Delta Dental Comparison sheet
- General Notice of COBRA Continuation Coverage Rights
- HIPAA Information – Notice of Privacy Practices
- 2019-2020 Rate Sheet Final
Miscellaneous Forms that cannot be completed on-line (see webpage for further details)
- Life Insurance Change of Beneficiary Form
- Life Insurance Evidence of Insurability Form
When you click on the Open Enrollment link, the page will provide you with a brief summary of the open enrollment material. This page will have direct links to the enrollment and change forms (located on the bottom of the page) as well as additional open enrollment information (located on the bottom of the page). Each link will provide you specific information pertaining to that benefit. Please review all of the
Benny Card Enrollment Form 2020, Delta Dental Change Form, Flexible Spending Account (FSA)
Election Form 2020 and Long Term Disability Insurance Tax Form: These links bring you directly to the electronic forms for the Benny Card Enrollment Form, Delta Dental Change Form, Flexible Spending Account (FSA) Election Form and Long Term Disability Insurance Form. You will need to complete the forms if and only if you are interested in enrolling in the Benny Card for Plan Year 2020, changing your dental insurance coverage, enrolling in the Flexible Spending Account (FSA) for Plan Year 2020, or changing the tax preference on your Long Term Disability premium. These forms must be electronically submitted no later than 4:00 p.m. on Friday, November 15, 2019. There will be no exceptions to this deadline date. If you are not making any changes AND you do not want to enroll in a Flex Spending Account for 2020, you do not have to do anything.
Miscellaneous Forms: Under this category, you have the option to download several reference documents and several forms that require hard copy submission. If you would like to increase your life insurance, you will need to download, print and complete the “Evidence of Insurability” Form. If you would like to change your life insurance beneficiary information, you will need to download and complete
the “Beneficiary Change Form”. These forms must be returned, hard copy, to my attention by 4:00p.m. on Friday, November 15, 2019.
All changes made during this open enrollment are effective January 1, 2020.
If you need assistance with the automated open enrollment process, staff will be available in the Benefits Department office from 8:00 a.m. to 4:00 p.m. to help you. If you have any questions, please email me at email@example.com or call 218-336-8723. Thank you.