Open Enrollment

 Benefits Open Enrollment 2014


We are pleased to announce the start of the 2014 Benefits Open Enrollment period at Lafayette College.  The Office of Human Resource’s offers one combined Open Enrollment period for your medical, dental, flexible spending, and supplemental life insurance coverage.

This year’s Open Enrollment begins on November 18, 2013 and continues through December 11, 2013. During Open Enrollment, employees may make changes to their benefits plans.  All of the plans offered during the Open Enrollment period are based on a calendar year (January 1, 2014 through December 31, 2014); therefore changes made during this period will be effective on January 1, 2014.

During Open Enrollment, you can make changes to your benefit plans without having to show evidence of a “life status change”.  Once you have made your elections, you cannot change them during the plan year unless you experience a life status change event as qualified under IRS regulations Section 125.


 Please refer to the Open Enrollment Brochure for all information regarding Open Enrollment for 2014:

Link to 2014 Open Enrollment Brochure

The medical and dental carrier  for 2014 will remain Capital BlueCross.   AmeriFlex will remain the Flexible Spending Administrator for 2014. Detailed information can be found in the Open Enrollment brochure.

Premium Rates – 2014


The following is a link to Lafayette’s Capital BlueCross webpage.  This customized site provides information and forms for employees making changes to their medical or dental plans for 2014.

 Link to Capital BlueCross

Keep in mind that if you are staying within the same PPO plan option (PPO1 or PPO2) for 2014, you do not need to complete a new enrollment form.  An enrollment form is only needed if you are newly enrolling in a medical or dental plan, changing coverage options, or changing covered dependent information.

Application to Enroll or Change Enrollment

Similarly, if you are remaining on dental coverage for 2014 with no changes, you do not need to complete a new enrollment form.


 Flexible Spending Accounts

Reminder: A new flexible spending enrollment form is needed for all employees (even those currently enrolled for 2013) enrolling in this program for 2014.

Link to AmeriFlex
 AmeriFlex Enrollment Kit
Ameriflex Enrollment Form
How to Use Your Card
FSA Calculation Worksheet
Quick Reference Guide
Medical FSA Rollover FAQ


 Optional Life Enrollment

Eligible employees are able to buy or increase their Supplemental/Optional Life coverage in increments of $10,000, up to 5 times their annual salary, not to exceed $500,000. Employees who are currently enrolled in optional life (at any amount) would be eligible to increase their optional life insurance by $20,000, without evidence of insurability, during this and future open enrollment periods.

Optional/Supplemental Life Enrollment Form (PDF)
Optional/Supplemental Life Enrollment Form (DOC)


Additional Forms

Below are additional links, to the various forms and plan information not available on the Capital BlueCross web site, that also pertain to your benefit selections during the 2014 Open Enrollment period.

Option to Waive Medical Dental Coverage Form (PDF) 
Medicare Part D Creditable Coverage Notice – Lafayette College