Enrollment Kits and Forms
Below you will find the new employee kit to use to orientate new employees on their health benefits. During an enrollment period you will find all the necessary information and forms located in this section.
New Employee Enrollment Kit for agencies/entities
This kit contains all the enrollment materials for new employees of agencies and entities.
Continuation of Coverage Rights Under COBRA
This explains COBRA continuation rights when health benefit plan coverage would otherwise end because of a life event known as a "qualifying" event.
BEACON online enrollment instructions
This document contains instructions for agencies who enroll through Employee Self Service (ESS).
eBenefitsNow online enrollment instructions
This document contains instructions for agencies who enroll through the eBenefitsNow system.
eBenefitsNow online enrollment instructions for retirees
This document contains instructions for HBRs who enroll retirees through the eBenefitsNow system.
HR InTouch website addresses
This document contains a listing of the HR InTouch website addresses along with links for agencies that are live on eBenefitsNow.
Change Form
This form is used for employees who wish to change their coverage (example, add a spouse or child).
Warehouse Requisition
Use this form to order enrollment kits and important forms.
Application for Reduction in Force Health Coverage Benefit
This form is used for RIF employees applying for health coverage.
Leave of Absence Form for Non-BEACON Agencies
If you are an employee with a Non-BEACON agency, this form provides options for health benefits while on a leave of absence.
