Page 3 - RS&A Benefits Enrollments Guide

How do I enroll?

Enrollment is handled via paper enrollment forms that can be submitted to your manager or
Human Resources department. If you are making changes to your current coverage you will
need to fill out a new form. Please review the following section regarding how and when to
make changes.

How/when to make changes

Unless you have a qualifying life event, you cannot make changes to the benefits you elect until
the next annual enrollment period. Qualifying life events include: marriage, divorce, legal
separation, birth or adoption of a child, change in child’s dependent status, death of spouse,
child or other qualified dependent, change in residence due to an employment transfer for you
or your spouse, or a change in spouse’s benefits or employment status. You have 30 days from
the date of the qualifying life event to notify Human Resources of any changes to your benefit
elections.

What if I need help?

If you have general benefit questions or need guidance, you may contact Human Resources or
one of the Allegacy Benefit Solutions representatives below:

 Lynne Fazenbaker 336-774-3481 lfazenbaker@allegacy.org
 Centrece Kendall 336-774-3425 ckendall@allegacy.org
 Leigh Shenberger 336-774-2838 lshenberger@allegacy.org
 Cheryl Grant 336-774-3451 cgrant@allegacy.org

This benefit guide is intended to be a brief overview only. Policy contracts are available by
contacting Human Resources. In the event that the information in this guide varies from the
information in the policy contracts, the provisions outlined in the contracts will govern.

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