TO: All RCUH Regular-status (50-100%) FTE Employees with or w/o Medical/Dental Plan
FROM: Nelson Sakamoto, Director of Human Resources
SUBJECT: RCUH HR URGENT – RCUH BENEFITS OPEN ENROLLMENT PERIOD Ends Friday, May 14th
REMINDER: All RCUH Open Enrollment Forms are due to RCUH Benefits (Email: [email protected]) by Friday, May 14, 2021. For detailed information regarding the RCUH Benefits Open Enrollment period, please refer to the Open Enrollment Informational Materials page and the announcement sent on Monday, May 3, 2021 (located below).
Frequently Used Forms:
- RCUH Group Health Insurance Waiver Form (OEB-5Wb) – Mandatory for all employees waiving medical coverage for the new plan year
- RCUH Flexible Spending Enrollment & Change Form (OEB-5F) – Re-enrollment mandatory for all employees wishing to participate in FSA Healthcare and/or FSA Dependent Care plans
- RCUH Group Health Plan Enrollment Form (OEB-5Ha)– Only required for new enrollments, changes to medical carrier or plan, change in coverage tier – add/remove dependents
Contact RCUH Employee Benefits for general inquiries on Open Enrollment, eligibility, and assistance with forms such as submission or filling them out.
Phone: (808) 956-6979 or (808) 956-2326 Fax: (808) 956-5022
Email: [email protected]