HRA Information: 2021 Enrollment and Change Period

2021 Enrollment and Change

September 28 - October 30, 2020

2021 Enrollment and Change Kick-Off Meeting

2021 HRA Kick-Off Meeting Recording (Passcode: JDT*7^7T
Slides of the benefits presentation PDF

Added-Value Tax Matrix

2021 Added-Value Tax Matrix PDF

2021 Deduction Schedules

2021 IowaBenefits Automatic Health and Dental P-1 Processing Schedule PDF
2021 Iowa Benefits Automatic Life P-1 Processing Schedule PDF 
  2020-2021 Health and Dental Deduction Schedule PDF 

2021 Health and Dental Insurance Premiums



All Employees (except SPOC-covered) PDF Non-Medicare Eligible PDF
SPOC-covered Employees PDF Medicare Eligible PDF

Verification/Documentation Forms


Flexible Spending Accounts (FSA)

FSA Tips and Tools for HRAs

Employee Resources 
2021 FSA Enrollment Brochure PDF 
FSA Brochure for Terminating Employees PDF

HRA Resources 
2021 Pay Period Calendar PDF (This calendar has the number of remaining pay periods per month. Helps when approving FSA enrollments and changes.)  
Flexible Spending Accounts When Terminating an Employee in IowaBenefits PDF
How To Change FSA Bank Information in IowaBenefits PDF
HRA Tips for Flexible Spending Accounts PDF

FSA Forms 
2021 Enrollment and Change FSA Enrollment Form PDF
2021 New Hires FSA Enrollment Form PDF 
ASI Flexible Spending Plan Change in Benefit Election PDF
FSA Claim Form PDF
FSA Prepayment Form PDF

Life Insurance

2021 Premiums

All Employee except SPOC-covered PDF
SPOC-covered Employees PDF

Waiver of Life And Long Term Disability Insurance PDF

Pay Period Calendar

2021 Pay Period Calendar 

Premium Conversion (Pre-tax) Program

Premium Conversion Form PDF

updated 10/14/2020