Annual Enrollment
Deadline: Nov 30, 2017 at 11:59pm ET
Enrollment Completed!
See Action Required below...
Here's a summary for your records
Confirmation number 14252120616
Submitted Nov 18, 2017 at 2:03 PM ET

You can make changes to this event until Nov 30, 2017 at 11:59 pm ET.

A record of this transaction will be saved in transaction history.
Per-Per-Pay-Period Cost$276.70
Pre-Tax$219.84
After-Tax$56.86
Make Changes
Action Required
  • Complete your Evidence of Insurability (EOI) Online - you have 30 days to complete your EOI for Employee Supplemental Life Insurance. Until your provider approves your completed EOI, you will remain enrolled in 3x Pay coverage at a cost of $10.50 per pay period.
  • Verify your dependents - because you have added a family member(s) to benefits coverage, you must provide proof of their eligibility for benefits. Failure to provide the requested materials by the deadline will result in their loss of coverage.
  • Make a COBRA payment - because you have enrolled in COBRA benefits coverage, you must provide payment. Failure to provide payment by the deadline will result in a loss of coverage.
Next Steps – now that you are done with your event, here are a few things to consider: