Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 446 •  Open enrollment period is October 17–November 10, 2016. •  Effective with the 2017 Open Enrollment period, WSSC will no longer be using Benelogic as the Benefits self-ser- vice system. Instead, employees will log in to One-Source and access Benefits Self Service, where they can update their benefit elections, dependents and beneficiaries. •  Please refer to the detailed instructions below. •  Any dependents covered on our plans were brought into One-Source. However, it is imperative that you log in to verify this information. •  Life insurance beneficiaries have been stored in the Benelogic portal and that information was NOT brought into Oracle. Even if you are not making changes to your benefits, you MUST log in to add your beneficiary information for the life insurance plan(s). •  During Open Enrollment, you have the following options: •  Change to a different health and/or dental plan. •  Enroll in a vision plan. •  Change coverage levels by adding or deleting dependents.** •  Waive health, dental and/or vision coverage for the 2017 Plan Year. •  Enroll, continue, increase or decrease coverage, or waive Supplemental Life Insurance. •  Enroll, continue, increase or decrease coverage, or waive Dependent Life Insurance. •  Enroll or waive Flexible Spending Accounts (both medical and dependent care). •  Enroll, continue, or waive coverage in the Sick Leave Bank Program. •  Enroll in the legal services plan. •  If you wish to change your WSSC Final Leave Pay, WSSC Retirement Plan and/or your ICMA or Empower Deferred Compensation beneficiaries, you will find these forms on the WSSC intranet or in the Human Resources Office. •  Flexible Spending enrollments do not rollover from the previous year. If you want to participate in flex spending in 2017, you must reenroll. •  All changes become effective January 1, 2017. •  If you are enrolling a dependent age 19–26 for the first time, you are required to complete an affidavit. Please see page 7 for information on dependent coverage. •  If you are changing plans, you should receive your health care cards no later than January 1, 2017. Other- wise, you will not receive a new card. •  Once Open Enrollment closes, your selections are bind- ing and cannot be changed, modified or canceled unless you have a qualified change of life event. See Change of Life Event section on page 8 for further details. Important Things To Remember WSSC Employee Self Service Benefits •  Log into WSSC’s One-Source. •  Select the WSSC Employee Self Service link and then select the Benefits link. •  Review the list of Dependents and Beneficiaries. If you need to add any new dependents or beneficiaries, click Add Another Person. Otherwise click Next. •  Dependent data was brought into One-Source from Benelogic, but other beneficiaries were not. You will need to add any beneficiaries if you do not see them listed. You will see your current benefit selections. The coverage start date for many plans will be listed as July 17, 2016. This is the date that data was brought in from Benelogic to One-Source and does not reflect your actual coverage start date. Below the current benefit selections are the dependents covered by each plan. Even if you are not making any changes, you will need to click Update Benefits so that you can assign beneficiaries for your life insurance plan(s). •  Scroll to review/update your Medical, Dental, Vision, FSA Health Care, FSA Dependent Care, Supplemental Life, Spouse Life, Child Life, Sick Leave Bank and Legal Services elections. •  Click Next to designate dependents for your Medical, Dental and Vision plans. •  Click Next to designate beneficiaries for your life insurance plan(s). •  Click Next to assign any Primary Care Physicians if necessary. •  Click Next to review all selections and click Confirmation Statement to view and PRINT A COPY FOR YOUR RECORDS. **PLEASE NOTE: Any benefits change to add or delete dependents requires legal documentation before benefits will be available. See Insurance Coverage for Dependents section on page 7.