2012-2013 OPEN ENROLLMENT INFORMATION AND FORMS

• PEEHIP Insurance, Supplemental Benefits & Flex Plan
• Link to PEEHIP Online Open Enrollment
• 2012 Open Enrollment Packet

Individual Enrollment/Change Forms

• Health Inusrance and Optional Plan Enrollment Form
• Health Insurance and Optional Plan Status Change Form
• Flexible Spending Enrollment Form
• Flexible Spending Status Change Form
• Federal Poverty Level Enrollment Form

Humana/CompBenefits Vision Care

Humana/CompBenefits Vision Enrollment/Change Form