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1 Making Open Enrollment Elections Open Enrollment is your opportunity to make changes to your benefit elections and add/ drop coverage for dependents s. The Claremont Colleges will be using the UltiPro portal to review, elect and submit their benefit choices for the following: Claremont McKenna College, Claremont University Consortium, Harvey Mudd College, Pitzer College & Scripps College. To make an Open Enrollment Election From the UltiPro home page, select Myself and a drop down menu will appear, click on Open Enrollment. The Open Enrollment page will appear. Make sure to read the entire Welcome Message for important Open Enrollment information. Once you have read the Open Enrollment information, click on the next button to begin your enrollment. 1

2 Edit, Add or Change Beneficiary and Dependent t Information If enrolling a dependent in coverage you must have their Social Security Number to continue with your enrollment elections. If you are enrolling a dependent for any type of coverage (medical, dental, vision) the dependent social security number is required and must be entered at the time of enrollment. Edit/Change Beneficiary or Dependent Information: 1. To edit information about a beneficiary or dependent, click on the Name link. The Add/Change Contact page appears. 2. Edit the information, as needed. Click Save. 3. The Verify Beneficiary and Dependent Information page will appear. Click next. Add a Beneficiary or Dependent: 1. To add a beneficiary or dependent, click Add. The Add/Change Contact page will appear. 2. Enter contact information, Click Save. 3. The Verify Beneficiary and Dependent Information will appear. Click next. 4. Click next. The Verify Beneficiary and Dependent Information page appears. When you are done making changes to the beneficiary or dependent information, click the next button. The Select a Plan page will appear. 2

3 Select a Plan Medical (Anthem HMO, Anthem Lumenos HSA and Kaiser) Anthem HMO Pre-Tax 1. Enroll: To enroll in the Anthem HMO plan, you must select one of three options. Employee Only, Employee + 1 or Family. (You may only make one selection). NOTE: For your reference, each benefit screen will display your Current Plan Election for Current Benefit Plan Election Elect or Decline this Medical Benefit IMPORTANT Information for new Anthem HMO Participants click more NOTE: You may choose only one medical plan for coverage. Please continue to the next screen(s) to view all medical options. Use the Back button to view the previous plans. 2. Decline: To plan. decline this benefit, select the I decline the Anthem HMO Pre Tax Once you have made your selection (Enroll or Decline), Click next. 3

4 Elect or Decline this Medical Benefit Click more for 2013 Benefit Changes Select a Plan Medical Cont. Anthem Lumenos HSA Pre-Tax NOTE: You may choose only one medical plan for coverage. Please continue to the next screen(s) to view all medical options. Use the Back button to view the previous plans. Please review the Benefit Changes for 2013 regarding the Anthem Lumenos HSA plan by clicking on the more tab. Once you have readd the changes for 2013, continue with your enrollment. 1. Enroll: To enroll in the Anthem Lumenos HSA, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To Tax plan. decline this benefit, select the I decline the Anthem Lumenos Pre Once you have made your selection (Enroll or Decline), Click next. 4

5 Select a Plan Medical Cont. Kaiser HMO Pre-Tax Elect or Decline this Medical Benefit NOTE: You may choose only one medical plan for coverage. Please continue to the next screen(s) to view all medical options. Use the Back button to view the previous plans. 1. Enroll: To enroll in the Kaiser HMO, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To decline this benefit, select the I decline the Kaiser HMO Pre Tax plan. Once you have made your selection (Enroll or Decline), Click next, you will move on to the Health Savings Account page. 5

6 Select a Plan Health Savings Account If you are enrolled Anthem HSA plan. in the Anthem HMO or Kaiser HMO plan, you may not enroll in the Elect or Decline this HSA Benefit NOTE: If you are enrolled in the Anthem HMO plan, you may not enroll in the Anthem HSA plan. If you elected the Anthem Lumenos HSA Thee Claremont Colleges will make a contribution to your Health Savings Account based on your benefit election. In addition to the employer contribution, you have the optionn to contribute to a Health Savings Account. (Note: A Mellon HSA account must bee opened by the employee in order to receive the employer contribution). 1. If you wish to contribute to your HSA account on a pre-tax basis, please enter a per pay period amount either under Single Coverage for Employee Only coverage or family coverage for Employee + 1 or Family coverage. 2. Decline: If you do not wish to contribute to the HSA account, please select the I decline Health Savings Account Plans. Once you have made your selection (Enroll or Decline), Click next, you will move on to the Kaiser Agreement page. 6

7 Select a Plan Kaiser Agreement Click more to view the Arbitration Agreement Elect or Declinee thearbitration Agreementt (If you elected Kaiser as your medical coverage you must agree to the Arbitration Agreement). If you have elected Kaiser HMO as your health care provider, you are required to read and accept the arbitration agreement. To read the arbitration agreement, click on the more tab to the right of the screen. Once you have read the arbitration agreement, click on the Accept/Enroll now. If you did not enroll in the Kaiser HMO plan, please click the I decline Kaiser Agreement Plans. If you have elected coverage, you must accept the arbitration agreement or the enrollment will not be accepted by Kaiser. Once you have made your selection (Enroll or Decline), Click next, you will move on to the Select a Plan Dental page. 7

8 Select a Plan Dental Effectivee January 1, 2013, MetLife Dental will be the dental carrier for The Claremont Colleges, replacing Delta Dental. Below is the first screen in the Dental Section. This screen is the first of two Dental Benefit screens (MetLife DMO and MetLife PPO). Please review the Dental DMO Pre Tax Plan Information by clicking on the more tab. Once you have read the MetLife Dental information for 2013, continue with your enrollment. If enrolling in the MetLife DMO plan you must choose a dentist and enter their facility ID code. You can locate a dentist and the dentist s facility ID code by visiting the MetLife website You will need to select Managed Dental Plan (Dental HMO), enter your zip code and click Go. 8

9 Select a Plan Dental Cont. After you click Go you must select a plan. Please select plan MET3757 from the drop down menu to access the network associated with the MetLifee HMO plan. After you have selected the plan, click Search to view the dentist in your selected area. You will find the Facility ID below the address on thee left hand side of the screen. You enter the Facility ID on the UltiPro MetLife HMO benefit screen. 9

10 Select a Plan Dental Cont. MetLife DMO Dental Pre-Tax Elect or Decline this Dental Benefit Click more for additional benefit Information and Transition of Orthodontic Care Form NOTE: You may choose only one dental plan for coverage. Pleasee continue to the next screen(s) to view all dental options. Use the Back button to view the previous plans. 1. Enroll: To enroll in the MetLife DMO Dental Pre-Tax plan, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To decline this benefit, Pre-Tax Plan. select thee I declinee the MetLife Dental DMO Once you have made your selection (Enroll or Decline), Click next. 10

11 Select a Plan Dental Cont. MetLife PPO Dental Pre-Tax Elect or Decline this Dental Benefit NOTE: You may choose only one dental plan for coverage. Please continue to the next screen(s) to view all dental options. Use the Back button to view the previous plans. 1. Enroll: To enroll in the MetLife PPO Dental Pre-Tax plan, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To decline this benefit, select the I decline the MetLife Dental PPO Pre- Tax Plan. Once you have made your selection (Enroll or Decline), Click next. 11

12 Select a Plan Vision The Claremont Colleges will continue to offer vision benefits through Vision Services Plan (VSP). VSP Core Pre Tax Elect or Decline this Vision Benefit NOTE: You may choose only one vision plan for coverage. Please continue to the next screen(s) to view all vision options. Use the Back button to view the previous plans. 1. Enroll: To enroll in the VSP Core plan, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To decline this benefit, select the I decline the Vision Core Pre Tax Plan. Once you have made your selection (Enroll or Decline), Click next. 12

13 Select a Plan Vision Cont. VSP Buy Up Pre-Tax Elect or Decline this Vision Benefit NOTE: You may choose only one vision plan for coverage. Please continue to the next screen(s) to view all vision options. Use the Back button to view the previous plans. 1. Enroll: To enroll in the VSP Buy Up Pre Tax plan, you must select one of three options, Employee Only, Employee + 1 or Family. (You may only make one selection). 2. Decline: To decline this benefit, select the I decline the Vision Buy Up Pre Tax Plan. Once you have made your selection (Enroll or Decline), Click next. 13

14 Select a Plan Flexible Spending Account (FSA) The Claremont Colleges offers three Flexible Spending Accounts: Dependent Care, Health Care and Individual Purchased Insurance Plans. You must elect or decline each benefit in order to complete your Open Enrollment for Flexiblee Spending Account Dependent Care Plan Elect or Decline this FSA Benefit Enter Amt. per pay period or Goal Amount. Minimum/Maximum Contributions NOTE: FSA contribution will be taken over twelve (12) months, beginning January through December 2013, as opposed to the 10 months in The 2013 annual contributions are; minimum $300 and maximum $5, Enroll: To enroll in Dependent Care Plan you must click on the FSA Dependent Care election and enter a per pay period amount that will be deducted from each paycheck in You may also choose to enter a Goal Amount instead of a amount in the Goal Amount section. If youu choose this option automatically calculate the per pay period contribution. per pay period the system will 3. Decline: To Plan. decline this benefit, select the I decline the FSA Dependent Care Once you have made your selection (Enroll or Decline), Click next. 14

15 Select a Plan - Flexible Spending Account (FSA)) Cont. Flexiblee Spending Account Health Care Plan Please note that the maximumm contribution allowedd for the Health Care FSA has been reducedd to $2500 from $5000. This change is mandated by the Health Care Reform Act. The minimum contributionn remains $300 for In addition, FSA contributionn will be taken over twelve (12) months, from January through December. Electt or Decline this FSA Benefit Enter Amt. per pay period or Goal Amount. The maximum contribution for the FSA Health Care Reimbursement account has been reduced to $2,500 for 2013, per Health Care Reform Act. FSAA contributionn will be taken over twelve (12) months, beginning January through December 2013, as opposed to the 10 months in FSA Health Care 1. Enroll: To enroll in the FSA Health Care plan, click on the FSA Health Care enter either an amount per pay period or a goal amount. (Note: the goal amount may not be greater than $2500.) 2. If you enter a Goal Amount, the system will automatically calculate the per pay period amount. (Example, Goal Amountt $2400 = Per Pay Period amount $ on a semi-monthly payroll schedule). 3. Decline: To decline this benefit, select the I decline the FSA Health Reimbursem ment Plan. Once you have made your selection (Enroll or Decline), Click next. Care 15

16 Select a Plan Flexible Spending Account (FSA) Cont. FSA Individual Purchased Insurance Plan 1. Enroll: To enroll in the FSA Individual Purchased Insurance Plan, click on the FSA Individual Purchased Insurance Plan., enter either an amount per pay period or a goal amount. Enter Amt. per pay period or Goal Amount. For detailed plan information click more FSA contribution will be taken over twelve (12) months, beginning January through December 2013, as opposed to the 10 months in For more information regardingg the Personally Paid Premium FSA click on the more button to the right of the screen for plan details. 3. If you enter a Goal Amount, the system will automatically calculate the per pay period amount. (Example, Goal Amount $24000 = Per Pay Period amount $ on a semi-monthly payroll schedule). 4. Decline: To decline this benefit, selectt the I decline the Purchased Insurance Plan. FSA Individual Once you have made your selection (Enroll or Decline), Click next. 16

17 Supplemental Life Insurance Please note that enrollment in Supplemental Spouse and Child insurance is not part of the 2013 Open Enrollment. You are eligible to enroll in and make change in these plans at any time throughout the year. All benefit eligible employees are automatically enrolled in Basic Life Insurance on their hire date. For more informationn regarding your Basic Life Insurance benefit and how to enroll in Supplemental Spouse and Child Life Insurance please refer to the Benefits Guide available on the CUC website. Select a Plan Accidental Death & Dismemberment You may elect Accidental Death and Dismemberment insurance for your family or yourself. Rate information may be obtained by clicking on the more link to the right of the benefit option. Enrollment in Supplemental Spouse and Child Life Insurance can be done at any time throughout the year. Select Coverage Type Family/Self Elect or Decline this Benefit Click more for complete rate table 1. Enroll: To enroll in either the family or individual plan, click on the desired benefit and enter a dollar amount based on the rate table. Note: AD&D coverage can exceed 10 times your annual salary. 2. Once you have selected a dollar amount, you will need to enroll your beneficiaries. You must designatee your beneficiaries as Primary or Secondary and assign a percentage. (Total percentage must equal 100%) 17

18 Select a Plan Accidental Death & Dismemberment - Cont. Select Beneficiary Name to edit. 1. The enrollment process is the same for individual as family coverage. For rate information click on the more button to the right side of the benefit screen. 2. Decline: To decline this Death/Disme ember Plan. benefit, select the II decline the Accident Once you have made your selection (Enroll or Decline), Click next. 18

19 You are almost done! Confirm Your Changes Once you have enrolled or declined all the benefit options, the Confirm Your Changes page appears. However, if you did not enroll or decline all benefit options you will see a purple box indicating that your elections cannot be submitted until elections for the required plan type( s) have been completed. The plans that need to be declined or elected will be listed in the purple box. You can usee the navigation bar on the left to go back and make the missing elections. Navigation Bar You must enroll or decline all plans. Note: If the Submit button is dim on the Confirm Your Changes page, the session was designed that the employee must elect or decline a plan for the plan type in order to complete and submit the Open Enrollment session. 19

20 Confirm Your Changes cont. 1. Verify the information on the Confirm Your Changes page. 2. Click the Print button to print the summaryy of your elections. Note: You must print beforee submitting your elections you will not be able to print after you submit. 3. Retain a copy of your confirmation n for your records Print Button 20

21 Confirm Your Changes cont. Submit Button Note: Don t forget to print the Confirmation Page before submitting your elections 1. Review the selected and declinedd benefit types. If you do not have any changes or errors, click Submit to complete your elections. 2. Please note that once you click Submit, you cannot make any further changes without the assistance of your Benefits Administrator. If you click OK, the Confirmation page appears. 3. Click Close. The Open Enrollment page status. appears and displays a Completed 21