Skip Navigation
This table is used for column layout.
Photos of O'Fallon
Link to Resident Info
Link to Business Info
Link to Visitor Info
Welcome to OFallon, Illinois
Green Decorative Header Bar
Spacer
Quick Links
 Community Profile
Departments
E-Government
Town Boards
Volunteer Opportunities
FAQs
Employment
Email Subscriber
Code of Ordinances
Public Documents
Contact Us
Useful Links
 




 
Open Enrollment 2010

Changes accepted from June 1 – June 30 noon

The insurance selections you make during this Open Enrollment Period
will be in effect from July 1, 2010 to June 30, 2011.

Understanding your benefit options requires effort on your part.  You need to review your benefit coverage and make the choices that best fit your needs for the next policy year.  This is the time to reinstate any waived coverage, add dependents, update student status or change from one type of plan to another (such as change from Dental PPO to HMO or vice versa).

If you want to add a non-student dependent, some additional information will be required.  Insurance for Full-time students is subsidized by the City.  For a non-student dependent, 100% of the coverage is bourne by the employee and could be taxable.

Changes to medical and dental coverage outside of an open enrollment period may only be made if the employee experiences a "major life event".   Examples of major life events are marriage, divorce, new child and some changes in the employment status of the employee or the spouse.  If you experience a major life event and wish to make any associated changes to your medical or dental coverage, you must complete the appropriate paperwork within 30 days of the event or wait until the next open enrollment period.

If you do NOT need to make any changes to you or your family's medical or dental insurance coverage, please check the appropriate boxes, print your name, sign & date below then return this to Human Resources on or before June 30th at noon.   If changes are needed, you will need to indicate those changes here and on the appropriate enrollment form as well.


REQUIRED. Return this form to Human Resources marked "I want changes" or "I don't want changes" indicated in the appropriate boxes. If no changes are requested, this is the only form you need to return.
Use this form to indicate changes for your HEALTH plan
Use this form to indicate changes to your VISION or DENTAL plan.
This includes a menu of health plan premium rates for July 1, 2010 - June 30, 2011
This handout describes the difference between the HMO and the PPO plans. The major differences are with the co-pay, deductibles, dental office designation, and annual maximum.
Contact Human Resources to discuss this non-student dependent coverage
 
Home Page Link
City of O'Fallon, IL
255 South Lincoln, O'Fallon, IL 62269
Tel: (618) 624-4500   Fax: (618) 624-4508
Click for O'Fallon, Illinois Forecast