Open Enrollment Header, April 26 - May 17, 2023

RCUH Open Enrollment FY 2024

Welcome to RCUH’s FY 2024 Open Enrollment! During this time, you will be able to review your current health coverage and make changes to best suit the needs of you and your family. Our Open Enrollment election period is April 26 – May 17, 2023. All changes will be effective July 1, 2023.


If you are satisfied with your current health (medical/dental) selections and do not plan to make any changes, no action is needed on your part. All employees who are currently waiving or choose to cancel their RCUH medical insurance plan are REQUIRED to submit a new eWaiver each plan year (July 1 June 30) via the eUpload feature. Please note that unlike health plans, Flexible Spending Accounts (FSA) Healthcare/Dependent Care does not automatically continue year to year. You must enroll/re-enroll into a FSA Healthcare/Dependent Care for each plan year if you want to participate.

Forms will be available on Wednesday, April 26, 2023. To access the OE forms, log into the RCUH Employee Self-Service (ESS) portal > click on eUpload > Click here to submit a new eUpload Request > click on the eUpload Type and select the form in the dropdown > click on Link to the document.

ActionFormRequired Supporting Documents
1) Health - Enroll/make changes for self01-Open Enrollment - All-in-OneN/A
2) Health - Add an eligible dependent - Spouse01-Open Enrollment - All-in-OneMarriage Certificate
3) Health - Add an eligible dependent - Domestic Partner01-Open Enrollment - All-in-OneDomestic Partner Forms
4) Health - Add an eligible dependent - Child01-Open Enrollment - All-in-OneBirth Certificate, Guardianship Degree (if legal guardian), or Adoption Decree
5) Health - Remove a dependent01-Open Enrollment - All-in-OneN/A
6) FSA - Enroll/re-enroll into an FSA Healthcare/Dependent Care01-Open Enrollment - All-in-OneN/A
7) Waive/Cancel Medical Insurance with RCUH02-Open Enrollment - eWaiverN/A

You can also contact RCUH Employee Benefits ([email protected]) for more information on the following actions:

  • Enroll yourself or a qualified family member in Supplemental Long-Term Care (subject to a medical questionnaire and/or underwriting)
  • Change your Group Life Insurance maximum coverage amount (subject to a medical questionnaire and/or underwriting)
Open Enrollment Dates
Open Enrollment Election PeriodApril 26 — May 17, 2023
Deadline for Enrollment Change Requests and Supporting DocumentsMay 17, 2023
Review Enrollment on Benefits Summary Page to Ensure AccuracyJune 5, 2023
New Coverage and Rate Changes
Premium and Plan Change Effective DateJuly 1, 2023
Health Premium — First DeductionReview July 7, 2023 Pay Statement
FSA Healthcare/Dependent Care — First DeductionReview July 21, 2023 Pay Statement
Benefit Periods
Plan Year Benefit PeriodJuly 1, 2023 — June 30, 2024
Calendar Year Benefit PeriodJanuary 1 — December 31, 2023
January 1 — December 31, 2024


Please submit all forms and documents using the eUpload feature in Employee Self-Service.


HDS logo

HMSA logo

Kaiser Permanente logo

NBS logo

(FSA/Pre-tax accounts)