Guide to Open Enrollment Forms

The following is a guide to the forms you will need to submit for 2006/07 Open Enrollment. *Note: All dependents must be listed on the Medical/Dental Elections form

	What you want to do:	Which forms to complete & submit
Medical REQUIRED
	Elect medical coverage for the 2007-2008 plan year	2007-08 Medical Election*
	Waive medical - have other group insurance Accept / reject College contribution to FSA	2007-08 Benefit Waiver (Parts A&C plus proof of qualified group coverage)
Dental
	Keep the same dental plan (for you and your dependents)	None
	Change from the EDS Dental Plan to United Concordia PPO/Indenmity Plan or Change from United Concordia PPO/Indemnity Plan to EDS DMO Plan	2007-08 Dental Election* To select your EDS dental provider, see page 10 of the Open Enrollment Guide.)
	Add or delete a dependent	2007-08 Dental Election*
	Elect dental coverage for the first time (you did not have dental coverage in 06/07)	2007-08 Dental Election*
	Waive dental	2007-08 Benefit Waiver -- Part A
Flexible Spending Account
	Contribute to a health care or dependent day care flexible spending account	2007-08 Flexible Spending Account (FSA) Enrollment
Life
	Keep exactly the same coverage	None
	Reduce PCC basic life insurance	Basic Life Insurance Election
	Increase PCC basic life insurance to 1.5 x Salary	Basic Life Insurance Election Sun Life Evidence of Insurability -- Cover Page & Health Questionnaire
	Elect Optional (supplemental) for the first time -- or -- Increase Optional (supplemental)	Sun Life Optional Life Enrollment Sun Life Evidence of Insurability -- Cover Page & Health Questionnaire
	Decrease or delete optional (supplemental)	Sun Life Optional Life Enrollment

* When completing either Medical and/or the Dental Election form, all covered dependents must be listed.