Employee Portal

Open Enrollment - October 5th thru November 9th, 2017

2018 Open Enrollment Health Insurance Information

Here is a link to the Health Plan Comparison Tool. If needed, you may request auxiliary aids and services or language assistance by calling Wellmark Customer Service at 800-524-9242. As a Wellmark member, these services are provided at no cost to you.

Plan A (HDHP) Summary of Benefits & Coverage (SBC)

Plan B ($500 deductible) Summary of Benefits & Coverage (SBC)

Wellmark Enrollment Form

          Rights & Responsibilities

FSA Election Form * MUST COMPLETE *

HSA Election Form * MUST COMPLETE IF ENROLLED IN HDHP *

          HSA Investment Options

          HSA Mutual Fund Options

                           If you wish to max out your HSA contributions, you would contribute as follows:

                           Single = $2,200 or $91.67 per pay

                           Family = $4,400 or $183.34 per pay

2018 Open Enrollment All Other Insurance Information

Delta Dental Change Form

Avesis Vision Enrollment Form

          Avesis Vision Benefit Summary Sheet

Dearborn National Enrollment/Change Form

          Dearborn National Evidence of Insurability * REQUIRED FOR APPLICATIONS IN                  EXCESS OF $50,000 *

          Life Insurance Needs Worksheet

457 Deferred Compensation Plan Employee Enrollment Form

Payroll Roth IRA Account Application Form

For beneficiary change forms, visit here.

____________________________________________________________________________

Click the button below for employee email/web mail access.

Employee Webmail

____________________________________________________________________________

Please plan to visit the Employee Portal regularly for HR

related news, notices and other helpful information. If

you have any questions, please contact Jamie at (515)

576-6869 or janderson@fortdodgeiowa.org.

Contact Us

In this Department

More Information

Stay Connected:

Facebook Twitter Click to Take A Video Tour of Fort Dodge