Download You must enroll in these benefits online between November 08

The FSI 2012 Benefit Open Enrollment Instructions for
January 01, 2012 - December 31, 2012
will be done online using the
Corporate Health Systems, Inc. (CHS) enrollment system.
As you review this document please note that the information within the
screen shots is for illustration purposes only. Dates and materials
contained in them are not always specific to your plan.
OPEN ENROLLMENT PERIOD:
You must enroll in these benefits online between
November 08, 2011 and November 17, 2011
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HOW TO LOGIN:
Step 1: Open your web browser (e.g. MS Explorer, Firefox, etc.) and log into the following website:
http://enroll.corphealthsys.com
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Step 2: Login using the following:
User ID: Your first initial, last name and the last 4 digits of your social security number (all one
word, all in lower case)
Example: If your name is John Smith and your social security number is 222-33-4444 your Username is:
jsmith4444. Your name is the name as listed on your pre-filled enrollment form without any special characters
(i.e. dashes, hyphens, commas, etc.)
Password:
fsi0110
The User ID, and password are CASE SENSITIVE, they must be entered as lower case.
Step 3: Change your password and log back in:
On your first login you will be prompted to change your password. Follow the instructions on the screen.
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Step 4: Select the Plan year of your open enrollment:
Step 5: Review and accept the Terms and Conditions of the enrollment:
You MUST review and accept the terms and conditions in order to proceed with the enrollment.
You will be guided step-by-step through the enrollment process, just follow along, enter the required information and
click
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button in the dialog box to update your personal information.
Step 6: Update your Personal Information:
Review your personal information for accuracy, make changes, and then press the
to save your changes. Click on
information.
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button
button in the dialog box to review/update your dependent
Step 7: Update and audit your Dependent Information (if any):
Note – for benefit purposes a spouse is considered a dependent as identified in the plan summary
document. Dependent information is also needed for the FSI provided dependent life insurance.
Please enter all dependent information.
In accordance with new Federal government regulations, you must include the Social Security Number and
date of birth for your spouse and all dependent children covered under the benefit plans.
If you are electing coverage for your dependent (spouse or child(ren)) they must meet the definition of a
dependent. If you are unsure if your dependent meets these criteria, please open the Eligibility link.
Also, all dependents must be certified before you will be able to enroll them in benefits. When you add a
dependent to the system, you can review the necessary documents you must submit to verify the dependent
by clicking on the
button.
If at any time during the plan year a dependent’s status changes, it is your responsibility to make the
appropriate changes to your coverage elections.
Select the
button to add a dependent. You must enter complete information for all
dependents that you intend to cover under the benefit plans.
Click the
radio button next to an existing dependent if you wish to edit that dependent’s personal information.
Please note that the system will prompt you for any incomplete data before it can save that dependent’s information.
When dependent information is completed click on
elections.
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button in the dialog box to make your
Step 8: Make Plan Elections.
You must elect your 2012 medical plan coverage.
Make any benefit changes by using the drop down boxes by any coverage that indicates “select option”. See
below screen print. Note: Any coverage with “
plan.
” next to the name has a link to more information about the
 Medical:
BlueCross BlueShield of Minnesota will continue as our health insurance administrator: HSA (Health Savings
Account) Health Benefit Plan. Please note that this benefit is available to all FSI employees working a minimum
of 20 hours per week.
 Health Savings Account:
Bancorp will continue to be our HSA administrator. If you are participating in the 2012 HSA Plan FSI will
contribute in January 2012 $325 for those electing employee only coverage, $650 for those electing employee +
1 coverage, and $975 for those electing employee + 2 or more coverage. In addition you may elect to make pretax contributions using the drop down menu above Health Savings – EE Portion (EE = employee portion),
these elections are annual amounts and can be changed monthly by contacting the FSI HR Benefits Department
and completing a HSA Employee Contribution Election Form. The IRS limits HSA contributions, for 2012 the
maximum annual amount (including the FSI contribution) for employee only coverage is $3,100 and $6,250 for all
other levels of coverage (employee + 1 and employee + 2 or more). If you are age 55 or older you may make
catch-up contributions up to an additional $1,000.
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You must elect your 2012 dental plan coverage
 Dental:
Delta Dental will continue as our dental administrator. Please note that this benefit is available to all FSI
employees working a minimum of 20 hours per week.
 Group Life/AD&D and Dependent Life Insurance:
CIGNA will continue as our group life and AD&D insurance carrier. The benefits will remain the same. FSI
International, Inc. will continue to pay 100% of the premium; enrollment is automatic.
 Supplemental Life and AD&D Insurance:
CIGNA is the provider for the supplemental life and AD&D insurance. This includes supplemental life and AD&D
coverage for employees, spouses and children. Rates and benefits will remain the same. This benefit is 100%
employee paid.
If you choose to increase your current supplemental life and AD&D insurance election for yourself, your eligible
dependents, or if you are adding coverage for the first time, you must complete an Evidence of Insurability (EOI)
form contained in the link. Your completed EOI form needs to be returned to HR Benefits Department, MS 48989 and coverage MUST be approved by the carrier before coverage will be effective.
 Long Term Disability (LTD) Insurance:
CIGNA will continue as our LTD insurance carrier. The benefits will remain the same. If FSI pays 100% of the
premium your LTD benefit is subject to taxes. If you prefer you may elect during open enrollment the option
to pay the premiums via payroll deduction, if you elect this option your LTD benefit would not be subject to taxes.
 Flexible Spending Accounts:
Corporate Health Systems, Inc. (CHS) will continue as our flexible spending administrator. If you wish to
participate in Flexible Spending you MUST make a new election by completing the FSA section. If you do not
make a new Flexible Spending election, you will not be eligible to participate in Flexible Spending for the new
plan year. The maximum health care FSA election will continue to be $5,000. If you elect to participate in
the High Deductible Health Plan with HSA you are only eligible for a “Limited Scope Health FSA”
which allows you to submit dental and optical expenses only. The maximum dependent care FSA
election will continue to be $5,000.
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Attention Benefit Card Participants:
If you participated in flexible spending account last year and have the Benny CHS Visa Debit Card, you must
elect to continue the debit card option by completing the debit card section. If you do not complete the debit
card section your card will be deactivated.
If you participated in flexible spending account last year and have the Benny CHS Visa Debit Card, do not
discard your card if you are electing to have FSA and the Benefit Card again for the new plan year.
You can continue to use the card you have for the new plan year if it is not expiring now. If your card is due to
expire, you will automatically receive a new card after the renewal process has been completed.
You will also have the option to have a debit card which will allow you direct access to the money in your FSA at
the time of service. Simply present your card to the provider of service; they will swipe your card and the funds
will be drawn from your FSA. Always keep your receipt as you may need to provide documentation to
CHS for the incurred expense. To elect to participate in this option, simply indicate your selection as shown
on the screen print below.
Don’t forget to press the
button. When your benefit elections are completed click on the
Calculated Premiums radio button, this will show both your monthly costs and FSI’s.
If you elect to enroll in the Flexible Spending Plans, Medical or Daycare, you will then have the option to
by clicking on the button at the bottom of the premium page (and as shown below).
You may also Go back to Elections to make changes and review your elections.
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Step 9: Reimbursement Method.
If you are enrolling in the Flexible Spending Plan, you can select to receive your reimbursements via check or
direct deposit.
Don’t forget to press the
button. When reimbursement method is completed click on
button in the dialog box to review the debit card option.
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Don’t forget to press the
button. When Debit Card method is completed click on
button in the dialog box to review/update your beneficiaries.
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Step 10: Add beneficiary information for life insurance:
Review your beneficiary information for accuracy. If you wish to make changes, do so, then press the
button to save your changes.
When you have completed your beneficiary information click on
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button.
Step 11: Confirm your enrollment.
Enter your email address and click
to complete your enrollment.
You will then receive an email with a confirmation of your elections.
Should you need to make adjustments, you can return to the site as often as you wish until the enrollment
period closes at midnight on November 17, 2011.
You will not be allowed to make any benefit changes to your elections after November 17, 2011, unless
you have a qualifying family status change.
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