Helping You Choose Your Plan
Benefits Eligibility
Dependent Eligibility
Plan Eligibility by Zip Code
Medical Provider Search
Prime Care Connect Guide
HIPAA Notice of Privacy Practices
Complete the PHA and receive a PHA Medical Plan Premium Credit up to $360 annually ($30/monthly pay; $13.85/biweekly pay). To complete the PHA, log in to YourPlanForHealth.com and click Personal Health Assessment under Get Started.
Enroll Manually
Open Enrollment 2012: November 16 - December 2, 2011.
You are strongly encouraged to use eBenefits to make your benefit changes for 2012.
The following are links to interactive PDF forms that may be filled-out online and then printed, or may be printed and then completed.
- Health Election (medical, dental, vision)
- Flexible Spending Account (health and dependent care)
- Life Insurance Beneficiary Designation
- Group Term Life Insurance Waiver of Entitlement
- Dependent Group Term Life Insurance (spouse/same-sex domestic partner, children)
- Voluntary Group Term Life Insurance (employees, spouse/same-sex domestic partner, children)
- Short-Term Disability Cancelation
- Out-of-Area Health Plan Election Form
- Affidavit of Same-Sex Domestic Partnership for Health and Life Insurance
- Affidavit of Sponsored Dependency For Health Care Coverage (includes opposite-sex domestic partners)
All hard-copy forms must be received by the Office of Human Resources Customer Service Center by 5 p.m. Friday, December 2, 2011.
The Office of Human Resources is located at 1590 North High Street, Suite 300, in South Campus Gateway (hr.osu.edu/customerservice).
