Welcome, Tom A. Adams
Enrollment Summary
Steps
1.
Instructions
2.
Personal Information
3.
Dependents
4.
Confirm Information
5.
Medical Benefits
6.
Dental Benefits
7.
Vision Benefits
8.
Disability Benefits
9.
Life & Accident
Benefits
10.
FSA Benefits
11.
Other Benefits
12.
Beneficiary
Information
13.
Confirm and Submit
VIEW CURRENT BENEFITS SUMMARY
Disability Benefits
Short Term Disability > Enroll
Please confirm the following information:
Enrollment Effective Date:
09/13/2001
Coverage:
60% of monthly Salary
Total Amount:
$5,000.00
Cost:
(per pay period)
Employee Cost:
$25.36
Company Cost:
$56.75
Note:
Place cost note here.
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