Open Enrollment Benefits – 01/01/2020 – 12/31/2020

a. Medical/Dental Enrollment Form (complete if electing to enroll, decline or change coverage)
b. Vision Enrollment Application (complete if electing to enroll, decline or change coverage)
c. Principal Enrollment Form for Voluntary Life, STD and LTD.
d. Statement of Health
e. * Principal Beneficiary Designation form
f. 401(k) Enrollment Form (Complete only to enroll in 401k)
g. * 401(k) Contribution Change Form (Complete only to change 401k contribution)