Open Enrollment
Faculty Open Enrollment 6/19/2023 - 8/16/2023
Changes to Dental/Vision Plan are effective 1/1/2024
- Open Enrollment Checklist
- The ACA (Affordable Care Act) Form
- Enrollment Plan Selection Forms for Medical
- Enrollment Plan Selection Forms for Dental
- Enrollment Plan Selection Forms for Vision
If you are adding a spouse/domestic partner to your SISC medical, dental or vision coverage: You must also complete the appropriate membership change form (medical, dental, and/or vision) AND submit two documents: a copy of the Marriage Certificate/Domestic Partnership paperwork and a copy of your 2022 Tax Return. These documents are required.
If you are adding a child(ren) to your SISC medical, dental or vision coverage: You must also complete the appropriate membership change form (medical, dental, and/or vision) and submit a copy of the child’s birth certificate. These documents are required.
If you are part-time and declining all coverage: Please complete the Declination of Coverage form.
Key Plan Information:
Additional Plan Information:
- SISC Benefit Booklet
- SISC Free Generic Medications Flyer
- SISC Vida Flyer - Personal Health Coach
- SISC Employee Assistance Program (EAP) Free Resources
- SISC Maven Maternity & Postpartum Support
- Delta Dental Plan A Summary
- Delta Dental Plan B Summary
- Delta Dental Plan C Summary
- Delta Dental Plan D Summary
- MetLife Voluntary Life Insurance Enrollment Form and Plan Summary
- MetLife Accidental Death & Dismemberment (AD&D) Insurance Enrollment Form and Plan Summary