enroll in benefits - extensis group€¦ · this is a step-by-step guide on how to enroll in...
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How ToEnroll in Benefits
For Employees
This is a step-by-step guide on how to enroll in benefits.
From the home page, click on "Benefits" followed by “Benefits Enrollment” from the navigation bar on the left side of the screen.
For Employees
How To Enroll in Benefits
The Benefits Enrollment screen will tell you when your enrollment period begins and ends. After reading the details, click “Next” to begin your enrollment.
BENEFITS ENROLLMENT SCREEN
ExtensisGroup.com
ESS HOME SCREEN
ExtensisGroup.com
On the “Dependent Form” you can enter dependents by clicking “+Add Dependent”.
Once you have entered all of your dependents, click “Next” to proceed.
***Note***
If your child is 26 or older, the
system will not allow them to be
enrolled in the plan.
Enter the dependent’s information.
Please note the information entered here is what will show in the insurance carrier’s system.
Be sure to select the appropriate “Relationship:” status.
DEPENDENT FORM
ExtensisGroup.com
Select which Enrollees you want covered on the plan.
Click on the plan name to select the plan.
Once you have made your selection, click “Next” to proceed.
***Note***
If you elect an HSA Plan (High
deductible Health Plan), you
will be prompted to enroll in an
HSA (Health Savings Account).
If not, you will not be prompted
to set up an HSA.
Click “View” to view benefit details for that plan.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Click the “Compare” button on each plan you wish to compare followed by the “Compare #/3” button to see a side by side comparison. You can compare up to 3 plans at a time!
Tip: Keep tabs on your
“Running Total” per pay check
by looking towards the top right
corner of the screen.
MEDICAL ELECTION FORM
PLAN INFORMATION AND COMPARISON
ExtensisGroup.com
Click on “Limits” to view the annual limit for an HSA.
Enter your annual election in the field.
If you do not wish to participate in an HSA, select the “I agree to waive health savings account benefits” option.
Click “Next” to proceed.
Tip: Keep tabs on your
“Running Total” per pay check
by looking towards the top right
corner of the screen.
Select which Enrollees you want covered on the plan.
Click on the plan name to select the plan.
Click “View” to view benefit details for that plan.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Click the “Compare” button on each plan you wish to compare followed by the “Compare #/3” button to see a side by side comparison. You can compare up to 3 plans at a time!
Once you have made your selection, click “Next” to proceed.
Tip: Keep tabs on your
“Running Total” per pay check
by looking towards the top right
corner of the screen.
HEALTH SAVINGS ACCOUNT ELECTION FORM
DENTAL ELECTION FORM
ExtensisGroup.com
Select which Enrollees you want covered on the plan.
Click on the plan name select the plan.
Click “View” to view benefit details for that plan.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Click the “Compare” button on each plan you wish to compare followed by the “Compare #/3” button to see a side by side comparison. You can compare up to 3 plans at a time!
Once you have made your selection, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
All active full-time employees automatically receive $10,000.00 in group life insurance through The Standard Life Insurance Company.
Provide beneficiary designations for the flat 10k life insurance here.
Your dependents’ information will appear here. Enter percentages for the primary or contingent amount for each beneficiary if applicable.
Add a new beneficiary by clicking “+Add Beneficiary” and entering the required fields.
Once complete, click “Next” to proceed.
VISION ELECTION FORM
FLAT 10K LIFE
ExtensisGroup.com
Enroll in additional voluntary life insurance here.
Move the slide bar to choose your coverage amount.
The cost per period will adjust as you increase and decrease the coverage amounts.
Click “Hide” to hide your coverage amount.
The Evidence of Insurability (EOI) form will appear if you select an amount higher than the guaranteed issue amount.
Be sure to complete this form to begin the process for approval for any amounts over the guaranteed issue, otherwise you will only have the guaranteed issue amount by default.
Once complete, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
Click “Limits” to view annual benefit maximums.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Enter your Annual Contribution in the field. Once you enter your annual contribution, the amount per period will adjust.
Note, if you enrolled in an HSA, you will only see the option to enroll in a limited medical FSA (LMED FSA).
Once complete, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
VOLUNTARY LIFE ELECTION FORM
FLEXIBLE SPENDING ACCOUNT ELECTION FORM
ExtensisGroup.com
Click “Limits” to view annual benefit maximums.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Click on the plan name and enter your Monthly Contribution in the field to select the benefit.
Once you enter your annual contribution, the amount per period will adjust.
Once complete, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
Click on the plan name to select the benefit.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Once complete, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
COMMUTER PLAN ELECTION FORM
PET ASSURE ELECTION FORM
ExtensisGroup.com
Click on the plan name to select the benefit.
Click the SBC button to view the summary of benefits and coverage document for additional information.
Once complete, click “Next” to proceed.
Tip: Keep tabs on your “Running Total” per
pay check by looking towards the top right
corner of the screen.
You can view additional voluntary benefits on this page.
Contact and access information will be provided for each benefit.
Click “Next” to proceed.
LEGAL ELECTION FORM
Review your elections on this screen.
If information is missing, click the edit button to go back to that form.
Once you are satisfied, click “Submit” to proceed.
Review the benefits enrollment terms and conditions.
Enter your first and last name followed by the “Complete Enrollment” button to finalize your enrollment.
Once you complete your enrollment you will see a confirmation statement.
Save the Benefit Confirmation Statement for your records.
SUMMARY AND CONFIRMATION
BENEFIT ENROLLMENT TERMS AND CONDITIONS
LEARN MOREVisit us at www.ExtensisGroup.com
© 2019 The Extensis Group LLC. All Rights Reserved.
Extensis is a registered service mark of The Extensis Group LLC, Woodbridge, NJ
0340C ED013119
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