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 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.

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