Complete your benefit elections online

New hire – benefit election form
Qualifying Event – Benefit Change Request Form

Please review the Changes to your Coverage tab for information on Qualifying Events

There are two medical plans to choose from, pick the one that’s right for you

Select the plan below to review the full Summary of Benefits and Coverage

Gold PPO $2,000
Platinum PPO  $500

Dental Summary
Dental Certificate of Insurance

Your employer will contribute $10 toward monthly dental premiums

   Vision Summary

Employees are responsible for the vision premiums

   Life and AD&D Summary and Rates

Voluntary Term Life – Premiums are age rated

   LTD Plan Summary

   Beneficiary Designation Form

The following AFLAC insurance polices are available to employees

For more information about policy benefits, limitations, and
exclusions, please call your Aflac insurance agent/producer,

Jennifer Goedken, at (480) 773-2068 or email

This is a brief product overview only.


An employer’s ability to allow employees to cancel or change health plan elections is governed by the Internal Revenue Code. Section 125 of the Internal Revenue Code (IRC) governs how employers provide benefits to employees on a pre-tax basis. After an employee has made an initial enrollment election, Section 125 does not permit changes outside of yearly open enrollment except for certain, specific reasons. The permitted Section 125 changes are the qualified “change-of-status” events described below:


A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.

There are 4 basic types of qualifying life events. (The following are examples, not a full list.)

  • Loss of health coverage
    • Losing existing health coverage, including job-based, individual, and student plans
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Turning 26 and losing coverage through a parent’s plan
  • Changes in household
    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  • Changes in residence
    • Moving to a different ZIP code or county
    • A student moving to or from the place they attend school
    • A seasonal worker moving to or from the place they both live and work
    • Moving to or from a shelter or other transitional housing
  • Other qualifying events
    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service
  • See all qualifying life events

Your Content Goes Here

New Hire Information

Employee Handbook
2018 Holidays and Paydays
Emergency Contact Form
Injury and Illness Prevention
Sexual Harassment
Workers’ Compensation Benefits

Employee Assistance Program offers services to help promote well-being and enhance the quality of life for you and your family

Click here to Learn More

Click the carrier links below  to be directed to their website


Contact us to learn more or to ask questions about your employee benefits package.

Becky Trujillo

Benefits Specialist