Welcome {firstName} {lastName}!
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Spouse Information:
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Child(ren) Information:
{groupName}Benefits Enrollment
Total Payroll Deduction{totalPer}{totalPer735}
Medical Plan Selection: {medicalPlan718}{medicalDecline}Medical Plan Coverage Tier: {medicalTier713}{medicalDecline}Medical Per Pay Period Deduction: {medicalPer}
Dental Plan Selection: {dentalPlan719}{dentalDecline}Dental Plan Coverage Tier: {dentalTier714}{dentalDecline}Dental Per Pay Period Deduction: {dentalPer}
Vision Plan Selection: {visionPlan720}{visionDecline}Vision Plan Coverage Tier: {visionTier716}{visionDecline}Vision Per Pay Period Deduction: {visionPer}
You have selected more than the Gurantee Issue Amount of {eevtlMaxgi355}. To get more than {eevtlMaxgi355}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
Employee Voluntary Life Amount: {eevtlAmt353} {eevtlDecline}Employee Voluntary Life Per Pay Period Deduction: {eevtlPer}
You have selected more than the Gurantee Issue Amount of {spvtlMaxgi}. To get more than {spvtlMaxgi}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
You have selected more than the Maximum Spouse Life Amount of {spvtlMaxadj395}. Please correct your selection.
Spouse Voluntary Life Amount: {spvtlAmt385} {spvtlDecline}Spouse Voluntary Life Per Pay Period Deduction: {spvtlPer}
You have selected more than the Gurantee Issue Amount of {eeOe406}. To get more than {eeOe406}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
Employee Voluntary Life Amount: {currentEe409}Employee Voluntary Life Per Pay Period Deduction: {eeEo420}
Employee Voluntary Life Amount: {eeOe414}Employee Voluntary Life Per Pay Period Deduction: {eeEo422}
You have selected more than the Gurantee Issue Amount of {spOe869}{spOe440}. To get more than {spOe440}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
You have selected more than the Maximum Spouse Life Amount of {spOe455}. Please correct your selection.
Spouse Voluntary Life Amount: {currentSp438}Spouse Voluntary Life Per Pay Period Deduction: {eeEo448}
Spouse Voluntary Life Amount: {spOe443}Spouse Voluntary Life Per Pay Period Deduction: {spEo446}
Child Voluntary Life Amount: {chvtlAmt649} {chvtlDecline}Child Voluntary Life Per Pay Period Deduction: {chvtlPer}
Child Voluntary Life Amount: {chvtlOe669} {chvtlOe670}Child Voluntary Life Per Pay Period Deduction: {chvtlOe672}
Should you become disabled and unable to work, this plan will pay you approximately {vltdEe} per month for up to {vltdBen}. Benefits begin after {vltdElimination} of disability.
Long-Term Disability Per Pay Period Deduction: {vltdPer}
Should you become disabled and unable to work, this plan will pay you approximately {vstdEe865} per week for up to {vstdBen}. Benefits begin after {vstdElimination} of disability.
Short-Term Disability Per Pay Period Deduction: {vstdPer}
{firstName} {lastName}{currentEe569} {currentEe570}
You have selected more than the Gurantee Issue Amount of {eeciMaxgi527}. To get more than {eeciMaxgi527}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
In order to increase your Critical Illness amount, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
Employee Critical Illness Amount: {eeciAmt531} {eeciDecline}Employee Critical Illness Per Pay Period Deduction: {eeciPer}
Current Employee Critical Illness Amount: {currentEe570} Current Employee Critical Illness Per Pay Period Deduction: {currentEe581}
New Employee Critical Illness Amount: {newEeci576} {eeOe577}New Employee Critical Illness Per Pay Period Deduction: {newEeci579}
In order to increase your Spouse Critical Illness amount, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
You have selected more than the Gurantee Issue Amount of {spciMaxgi554}. To get more than {spciMaxgi554}, you will need to complete a health questionnaire that will be automatically emailed to you once you complete enrollment.
You have selected more than the Maximum Spouse Life Amount of {spciMaxadj553}. Please correct your selection.
Spouse Critical Illness Amount: {spciAmt558} {spciDecline}Spouse Critical Illness Per Pay Period Deduction: {spciPer}
Current Spouse Critical Illness Amount: {currentSp585}Current Spouse Critical Illness Per Pay Period Deduction: {currentSp587}
New Spouse Critical Illness Amount: {newSpci595} {spOe597}New Spouse Critical Illness Per Pay Period Deduction: {newSpci599}
Accident Plan Selection: {accidentPlan721}{accidentDecline}Accident Plan Coverage Tier: {accidentTier717}{accidentDecline}Accident Per Pay Period Deduction: {accidentPer}
Employee Information:
Address: {address}Annual Salary: {annualSalary}
Annual Salary: {annualSalary}
Spouse Information: {spno}
{additionalCh}
Child(ren) Information: {chno}
Medical Plan{currentMed}
Plan Selection: {medicalPlan803}{medicalDecline}Coverage Tier: {medicalTier804}{medicalDecline}Payroll Deduction: {medicalPer}
Dental Plan{currentDent}
Plan Selection: {dentalPlan806}{dentalDecline}Coverage Tier: {dentalTier805}{dentalDecline}Payroll Deduction: {dentalPer}
Vision Plan{currentVis}
Plan Selection: {visionPlan808}{visionDecline}Coverage Tier: {visionTier807}{visionDecline}Payroll Deduction: {visionPer}
Empolyee Voluntary Life Plan
Elected: {enrollIn351}Amount: {eevtlAmt353}Payroll Deduction: {eevtlPer}
Empolyee Voluntary Life Plan (OE)Previous Amount: {currentEe409}
Elected: {whatChange}Amount: {eeOe414}Payroll Deduction: {eeEo422}
Spouse Voluntary Life Plan
Elected: {enrollIn374}Amount: {spvtlAmt385}{spvtlDecline}Payroll Deduction: {spvtlPer}
Spouse Voluntary Life Plan (OE)Previous Amount: {currentSp438}
Elected: {whatChange432}Amount: {spOe443}Payroll Deduction: {spEo446}
Child(ren) Voluntary Life Plan
Elected: {enrollIn642}Amount: {chvtlAmt649}{chvtlDecline}Payroll Deduction: {chvtlPer}
Child(ren) Voluntary Life Plan (OE)Previous Amount: {currentCh656}{chNot}
Elected: {enrollIn663}Amount: {chvtlOe669}Payroll Deduction: {chvtlOe672}
Long-Term Disability{vltdprevious}{vltdCurrent}
Elected: {enrollYourself}Payroll Deduction: {vltdPer}
Short-Term Disability{vstdprevious}{vstdCurrent}
Elected: {enrollYourself487}Payroll Deduction: {vstdPer}
Employee Critical Illness
Elected: {enrollIn520}Amount: {eeciAmt531}Payroll Deduction: {eeciPer}
Employee Critical Illness (OE)Previous Amount: {currentEe570}
Elected: {enrollIn520}{oeEnrollment}Amount: {eeciOe}Payroll Deduction: {eeciOe724}
Spouse Critical Illness
Elected: {enrollIn544}Amount: {spciAmt558}Payroll Deduction: {spciPer}
Spouse Critical Illness (OE)Previous Amount: {currentSp585}
Elected: {changeSpouse}Amount: {newSpci595}Payroll Deduction: {newSpci599}
Accident Plan{currentAcc730}
Plan Selection: {accidentPlan810}{accidentDecline}Coverage Tier: {accidentTier809}{accidentDecline}Payroll Deduction: {accidentPer}
Total Payroll Deduction: {totalPer}
Total Payroll Deduction: {totalPer735}