Page 5 - 2022 Fives Landis Corp Benefit Guide

QUALIFIED LIFE EVENTS

Generally, you may change your benefit elections only
during the annual enrollment period. However, changes
to your benefit elections during the year may be made You must notify Human Resources within 31 days
if you experience a qualified life event, including: of the qualified life event. Depending on the type
— Marriage of event, you may be asked to provide proof of
— Divorce or legal separation the event. If you do not contact Human Resources
— Birth of your child within 31 days of the qualified event, you will have
— Death of your spouse or dependent child to wait until the next annual enrollment period to
— Adoption of or placement for adoption of make changes (unless you experience another
your child qualified life event).
— Change in employment status of employee,
spouse or dependent child
— Qualification by the Plan Administrator of a
child support order for medical coverage
— Entitlement to Medicare or Medicaid

ENROLLING IN YOUR BENEFITS

COMPLETE YOUR ENROLLMENTS: KEY CONSIDERATIONS FOR 2022:
— Log on to ADP at workforcenow.adp.com.
If the enrollment page does not display go to tab Medical Plan: Plan option change, previous $750 plan
Myself <Benefits<Enrollments. has moved to a $1,000 plan option.
— New Hires: Enroll within 31 days of date of hire.
— Open Enrollment: for 2022 elections, enroll Vision: Coverage remains with VSP. An Enhanced
November 3 - 17 . higher coverage level plan has been added (page 8).
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rd

RESOURCE ASSISTANCE: Re-enroll in a Health, Dependent Care or Limited Flex-
— On ADP: Under Resources< Tools/Resources find ible Spending Account (FSA), even if currently enrolled
presentation, videos, summaries, etc. - a new election must be made each year.
— Voya Plan Information: presents.voya.com/EBRC/Fives
— Direct Path: Call customer service at 866-253-2273 Fives Retirement Savings Plan: Review information
or Email: advocate@directpathhealth.com in the Open Enrollment checklist on annual auto en-
See page 10. rollment and auto percent increase – take action as
— Carrier Contacts: See page 17 for applicable appropriate.
information.

A key resource for all your benefit information,
plan documents, claim forms, phone numbers,
website links, etc. can be found on ADP under
Resources<Tools/Resources.
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