The document provides information for employees on enrolling for benefits during the open enrollment period from October 1 to November 15. It states that employees must complete a hospital enrollment form by November 15 for health insurance to be effective January 1, 2007. It also notes that employees must complete a flexible spending plan form each year and that dental insurance will continue as is unless an employee requests a change from HR. Finally, it mentions that after November 15, changes can only be made within 30 days of a qualifying event and provides contact information for the HR benefits representative.

1. IT’S TIME TO CHOOSE
YOUR BENEFITS!
All you need to know for successfully enrolling
for your benefit plan.
2006 ABC Company, Inc.

2. How do I enroll?
 You must complete a
Hospital enrollment form in
order to have health
insurance become effective
on 01/01/2007.
 Return completed enrollment
form(s) to HR no later than
4:30pm, November 15.

3. How long do I have?
 The open enrollment period
runs from October 1 –
November 15.
 All changes are effective
January 1, 2007.

4. What about my Flex Spending Plan?
 You must complete a
form every year to
participate in the
flexible spending plan.
 The flexible plan
election is effective
01/01/2007.

5. What about my Dental Plan?
 Dental insurance will
continue as it is.
 Request a form from HR if
you want a change.

6. What if I change my mind?
 Changes cannot be
made to your benefits
after November 15,
except within 30 days
of a “qualifying
event.”

7. Questions? Contact the HR Department at x1234.
Ask for the Benefits Representative.