Open Enrollment Checklist Read over the September 2015 Wellness at WellStar Open Enrollment Edition to learn what

changes are occurring with your 2016 benefits.

□ If you do not plan on making any changes to your benefits during open enrollment, the Benefits Department highly recommends that you review your current benefit elections to ensure you and your family are enrolled into the correct plans for 2016. Once open enrollment ends, October 31, 2015, you will not be able to make changes to your benefits unless you have an IRS qualified status change.

□ Read all the Benefit Plan Descriptions and Eligibility Requirements on the MyBenefits portal

before making any elections or changes to your benefits. □ To elect or make changes to your benefits, click the Enroll Now button on the Welcome Page of

your MyBenefits portal. □ Look over the Review Your Information enrollment screen to ensure your personal information

is correct. Some fields will allow you to make changes, others will require you contact a Benefit Communications Administrator at 1-888-926-2992 to add, change or correct information.

□ The Benefits Summary section of your enrollment lists all your current benefits. You can choose

to click on Take Me Through Each Benefit and allow the system to walk you through every benefit screen or click on Make Changes next to the benefit(s) you want to see. To avoid missing benefit elections and errors in your enrollment, the Benefits Department recommends you choose to click on Take Me Through Each Benefit.

□ If you elect or change to a non-tobacco user status during Open Enrollment, you are claiming that

you and any dependents covered on the medical plan have been tobacco free over the last 6 months.

□ If you are electing an HSA for the first time, you will need to read over the information on the

HSA enrollment screen and follow the directions to ensure your HSA account is opened and able to receive the WellStar employer contribution for 2016.

□ If you currently have an active and open HSA, the WellStar employer contribution will be

deposited by 1/1/2016. Your 2015 HSA contribution election will carry-over to 2016. It is very important that you make sure your election is what you want it to be for 2016. If you plan on contributing the full IRS allowed amount, you will need to adjust your election as the IRS limit for team member + 1 and family coverage has increased for 2016.

□ FSA elections must be elected every year. If you plan on enrolling into the Dependent Care or

Healthcare FSA for 2016, you will have to actively enroll. Note: If you have or plan on enrolling into an HSA and enroll into a Healthcare FSA, your Healthcare FSA will be limited to dental and vision expenses only until you have satisfied your medical plan annual deductible.

□ If you elect Permanent Life Insurance during open enrollment, your election will pend until you

have met with a Benefit Communication Counselor to complete your enrollment process. Counselors will be available at all the computer labs.

□ When you have completed making your elections or changes, you will be directed to Review Your Benefit Elections. You need to review this in great detail to make sure all your elections and changes are correct and then click Complete Enrollment. PRINT YOUR BENEFIT SUMMARY for record keeping.

□ Newly added dependents will need to be verified by our outside Dependent Eligibility Audit

Firm. Information on how and when you are to submit verification will be sent to you in November/December 2015. Make sure you address is correct in Lawson Self-Serve.

□ Be sure to complete any Evidence of Insurability Forms (EOI) for election increases in Optional

Employee and Dependent Life Insurance. Your Benefit Summary will indicate if you are required to complete EOI forms.

□ If you have FSA or HSA Visa cards, and elect these benefits for 2016, be sure to check the

expiration date on your cards. Any cards expiring will be sent new cards close to their expiration date. Do not throw away these cards if they are not expired.

□ Pending Permanent Life elections need to be completed with a Benefit Communication Counselor

within 90 days of enrolling. □ If you have a 2015 Dependent Care or Healthcare Flexible Spending Account, remember to use

all funds by December 31, 2015 to avoid forfeiting account funds. Receipts for purchases made in 2015 may be submitted for reimbursement up through March 31, 2016.