PEEHIP Open Enrollment
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PEEHIP open enrollment allows full-time employees to add and/or change your health, supplemental and flexible spending benefits. There is no wait for pre-existing conditions during open enrollment. You may add or delete coverage for yourself or family members. You may also combine allocations with a spouse that is employed at JSU or elsewhere in Alabama Public Education.

The Open Enrollment period begins July 1st and ends August 31st for changes to be effective October 1st. All Open Enrollment forms and written requests must be postmarked no later than August 31 for the PEEHIP office to accept the request. This year, PEEHIP will NOT mail the Open Enrollment packets to your home address. Instead, all active and retired members should have received or will receive a one page notice that informs you of the current coverage in which you are enrolled, as well as other general open enrollment information. The Open Enrollment booklet and forms will be available on the RSA website shortly on or after July 1st. Members can download the information and forms, or members can make changes using the Member Online System. All hardcopy forms are to be mailed directly to PEEHIP at the address indicated on the form.

If members do not wish to make changes to their PEEHIP coverage, they do not need to complete the Open Enrollment application. They will remain enrolled in the same or existing plan(s), and the appropriate premium will continue to be deducted. (Please see below for exceptions)


Employee rates are listed below.
PEEHIP Family $177.00
PEEHIP Single $15.00
Dental $38.00-single $45-family
Vision (family or single) $38.00
Cancer (family or single) $38.00
Hospital Indemnity (family or single) $38.00
Supplemental Coverage $38.00
Tobacco User Surcharge $28.00
Flexible Speding Plan Maximum contribution $2,500 per plan year.

Options for making open enrollment changes:
Online - open enrollment changes can be made online at mso.rsa-al.gov.

Mail - complete the appropriate forms provided by PEEHIP in the Open Enrollment Booklet and return to PEEHIP on or before the open enrollment deadline.

Form(s)to Request Reason
New Enrollment and Status Change Application

New Enrollment / Add or Delete Family Members/Coverage
Medicare Information
Other Health Insurance Information

*Flexible Spending Enrollment Application Add Healthcare & Dependent Care Spending
Open enrollment deadline for FLEX PLAN ONLY - Sept. 30
*Federal Poverty Level Discount Application Apply for Federal Poverty Level Discount Enroll dependent children into CHIP

* Members who want to participate in the PEEHIP Flexible Spending accounts and the Federal Poverty Level Premium Discount ARE REQUIRED TO RE-ENROLL EACH YEAR. These programs do no automatically renew each year without a new application. OPEN ENROLLMENT DEADLINE FOR THE FLEXIBLE SPENDING PLAN ONLY IS SEPTEMBER 30.