HRA Information: 2022 Enrollment and Change Period

2022 Open Enrollment

September 27 - October 29, 2021

2022 Open Enrollment Kick-Off Meeting

2021 HRA Kick-Off Meeting Recording (Passcode: a78vi%^t
Slides of the benefits presentation PDF

Added-Value Tax Matrix

2022 Added-Value Tax Matrix PDF

2022 Deduction Schedules

2021-2022 Health and Dental Deduction Schedule PDF

2022 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 
2022 FSA Enrollment Brochure PDF 
FSA Brochure for Terminating Employees PDF

HRA Resources 
2022 Pay Period Calendar PDF (This calendar has the number of remaining pay periods per month. Helps when approving FSA enrollments and changes.)  

FSA Forms 
FSA Claim Form PDF
FSA Prepayment Form PDF

Life Insurance

2022 Premiums

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

Waiver of Life And Long Term Disability Insurance PDF

Pay Period Calendar

2022 Pay Period Calendar 

Premium Conversion (Pre-tax) Program

Premium Conversion Form PDF

updated 09/28/2021