Waukesha County

Open Enrollment for 2018 has closed.

Contact Human Resources at

262-548-7044 for assistance regarding Qualifying Events.

Open Enrollment runs October 2, 2017 through November 3, 2017 for changes to be effective January 1, 2018. All completed forms should be returned to the Human Resources Office.

Health Insurance Forms / References
UnitedHealthcare Enrollment Form
Optum Bank HSA Application Form (must be completed when enrolling in HSA Health Plan)
Employee HSA Contribution Form
Summary Plan Description - ChoicePlus PPO
Summary Plan Description - HSA Health Plan
Standard Walgreens Pharmacy Network - Complete Pharmacy Listing (July 2017) Stay tuned for 2018 listing.
$0 Cost Preventative Medication List

Health Savings Account (HSA) Education Materials

Making the Most of Your HSA Presentation
HSA User Guide
HSA Qualified Expenses
HSA Optum Bank Receipt Vault Flyer
HSA and Medicare Flyer
HSA Investment Guide
HSA Investment FAQ Document
HSA Investing PowerPoint
What is an HSA PowerPoint

Important Websites:

Additional Resources:
UnitedHealthcare New Member Guide
Premium Provider Program

Delta Dental Insurance
Enrollment/Change Form
How to locate a Network Provider
website: www.deltadentalwi.com

Dentacare Dental Insurance
Enrollment/Change Form (Must designate a Dentacare Center -- Only one center may be selected)
Provider Online Search
Dentacare Standard Provider Directory (as of 8/17/2016)
website: www.Anthem.com

Vision Insurance
Enrollment/Change Form
Online Provider Search
website: www.superiorvision.com

Flexible Spending Accounts
Participants must re-enroll for each year. Current elections do not carryover into the new plan year.
Enrollment Form
website: www.ebcflex.com