Open Enrollment

2023 Open Enrollment Instructions

Listed below are the benefit descriptions and enrollment forms for the Village’s benefit plans that are open for enrollment by eligible employees with a benefit effective date of July 1, 2023.  Information regarding the Employee Assistance Program (available year-round), and mandated annual benefits report information is also provided below. Please view the Open Enrollment Benefits Summary and Employee Rate Sheet before visiting the individual benefit topics.

2023 Benefit Summary & Rate Sheet

  1. Benefit Summary July 2023
  1. Rates July 2023

BCBS & Opt-Out Health Plans

  1. BCBS_PPO_HMO_BAHMO_Enrollment Form
  2. BCBS Enrollment Guide
  3. Opt-Out 2023

Delta Dental Insurance

  1. Dental Enrollment Form (PDF)
  2. Dental Enrollment Guide 2023

VSP Vision Insurance

  1. VSP Vision Enrollment Form
  2. VSP Plan C Information
  3. VSP.COM - How to Create Your Own Account
  4. VSP DEP Plus Program
  5. Laser VisionCare (1)
  6. Exclusive Member Extras (1)
  7. Essential Medical Eye Care
  8. Combat Digital Eye Strain

Annual Notifications

  1. Summary_of_Benefits_BAHMO
  2. Summary_of_Benefits_HMOI
  3. Summary_of_Benefits_PPO
  4. Health Insurance and Market Place Coverage
  5. COBRA NOTICE
  6. CHIPRA State Premium Assistance Notice
  7. HIPAA Privacy Policy
  8. HIPPA Privacy Notice
  9. HIPPA Special Enrollment Rights
  10. Medicare_Certificate of Creditable Coverage_2020
  11. Newborns and Mothers Health Protection Act Disclosure
  12. Childrens Health Insurance Program - Medicaid
  13. Womens Health and Cancer Rights Act
  14. PPACA Section 1557 Notice
  15. HIPAA Privacy Notice
  16. Womens Health and Cancer Rights Notification

Discovery Benefits FSA

  1. FSA Enrollment Form
  2. FSA and Dependent Care Contribution Limits
  3. Recurring_Dependent_Care_Request_Form_9.1.21
  4. Benefits_Mobile_App_Handout_9.1.21
  5. Benefits_Technology___Resources_Employee_Handout_11.2021

Supplemental Life Insurance

  1. Securian Supplemental Life Insurance Enrollment Form
  2. Securian Basic and Supplemental Life Info
  3. Securian Life Application Process Info
  4. Securian Beneficiary Designation Form
  5. NCPERS Enrollment Form
  6. NCPERS IMRF Brochure
  7. NCPERS Beneficiary Form
  8. NCPERS Change of Address Form

Express Scripts Rx Drug 

  1. Smart90 for Maintenenace Medications
  2. Specialty Brochure
  3. Express Scripts Mobile App
  4. Mobile App
  5. ESI Mobile App and Web - Print and View Member ID Card
  6. Home Delivery

Other Benefits

Aflac

  1. AFLAC Policies

Employee Assistance Program

  1. EAP_Overview Flyer_US_ENG 2021 IPBC
  2. Depression_Anxiety
  3. Financial Wellbeing
  4. LegalResources

Credit Unions (Corporate America (CAFCU) & DuPage (DCU)

  1. CAFCU_Financial One-on-One Flyer
  2. CAFCU_Pay Yourself First
  3. DCU_2021_Benefits-Flyer
  4. DCU_Banking-Inspired_Brochure