*CLOSED* Open Enrollment 2020

Open Enrollment ends Friday, November 1st. All paperwork must be turned in or your benefits may be delayed.

Wellmark

Summary of 2020 Health Insurance Plans
 
Complete the Wellmark Change Form only if you want to switch plans next year (effective 1/1/2020).
Wellmark Blue Cross/Blue Shield Enrollment Change Form
 
REQUIRED EMPLOYEE NOTICES
Plan A (HDHP) Summary of Benefits & Coverage
Plan B (PPO) Summary of Benefits & Coverage
Creditable Coverage Notice
Children's Health Insurance Program (CHIP) Notice
Your Rights & Responsibilities
  Includes: Genetic Information Nondiscrimination Act (GINA), Special Enrollment Notice, Notice of Women's Health and Cancer Rights Act and Wellmark's Privacy Practices Notice
   
TIPS & TRICKS
Plan Comparison Tool
Doctor on Demand

 

WageWorks

ALL health insurance benefit eligible employees MUST complete the Flexible Spending Account (FSA) form. (This form must be completed each year, even if you're not changing plans.)
Flexible Spending Reimbursement Account Enrollment Form
2020 Contribution Limits COMING SOON
 
Complete the Health Savings Account (HSA) Form ONLY if enrolled in the City of Fort Dodge HDHP insurance plan.
Health Savings Account Enrollment Form
HSA Limits 2020
     
ADDITIONAL FORMS
   
Dependent Care Account Reimbursement Form
Health Savings Account Designation of Beneficiaries Form
Health Savings Account Information Change Form
 
TIPS & TRICKS
Healthcare Card Top 5 Usage Tips
Card Use Verification FAQs

   

Dental

Complete only if making changes to current enrollment.
Delta Dental Enrollment Change Form
 
TIPS & TRICKS
Delta Dental Benefit Summary
Deltavision Discount Program

 Avesis Vision

Complete only if making changes to current enrollment.
Avesis Vision Enrollment Change Form
 
TIPS & TRICKS
Avesis Vision Benefit Summary
Avesis

Contact Us

In this Department

More Information

Stay Connected:

Facebook Twitter Click to Take A Video Tour of Fort Dodge