Open Enrollment

2022 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, 2022.  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:

2022 Benefit Summary & Rate Sheet

  1. Benefit Summary_7-1-2022
  1. Employee Rates_7-1-2022

BCBS & Opt-Out Health Plans

  1. BCBS_ENROLLMENT GUIDE
  2. BCBS_PPO_HMO_BAHMO_Enrollment Form
  3. Health Insurance Opt-Out 2022

Delta Dental Insurance

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

VSP Vision Insurance

  1. IPBC VSP Plan C
  2. VSP Vision Enrollment Form
  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. Womens Health and Cancer Rights Notification

Discovery Benefits FSA

  1. FSA Enrollment Form
  2. FSA_Dependent_Care_Contribution_Limits_IRS_Regulations_Handout_12.2021
  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. The Standard Supplement Life Info
  2. The Standard Insurance Enrollment Form
  3. NCPERS Brochure
  4. NCPERS Enrollment Form
  5. NCPERS - Beneficiary 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