10-07-2025, 03:43 AM
FlexElect options employees may choose. Please keep in mind these are examples to help illustrate what form(s) should be completed. With every different situation and dates involved, the form(s) will be completed differently.
Each example begins with an explanation of the employee's current status, his/her desired FlexElect elections, and the actions required by the employee, his/her spouse or domestic partner, and the Personnel Office.
In all examples, the "employee" is the State employee and is the principal figure in the scenario. The "employee's spouse or domestic partner" in some examples is a State employee or may be employed by private industry.
The information/examples in this manual c level executive list does not reflect every possible type of enrollment/change within FlexElect but hopefully provide a broad range of enrollment and change situations.
Example - Open Enrollment/Cash Option (New Enrollment)
SITUATION: Open Enrollment, Cash Option for Medical and Dental - New Enrollment, Spouse or Domestic Partner Also a State Employee.
![[Image: c-level-executive-list-5.png]](https://i.postimg.cc/65T5JsHr/c-level-executive-list-5.png)
Employee is currently enrolled in his own State-sponsored medical and dental insurance plans. Employee's spouse or domestic partner, who is also a State employee, is currently enrolled in her own State-sponsored medical and dental insurance plans. Spouse or domestic partner is not currently covering any dependents.
DESIRED FLEXELECT ELECTIONS
Employee wants to enroll in FlexElect for the Cash Option in lieu of his own State-sponsored medical and dental insurance plan.
ACTION REQUIRED
Employee must complete a STD. C to enroll in the Cash Option. Employee must also complete an HBD- and a STD. to cancel his own medical and dental insurance.
Spouse/Domestic Partner must complete an HBD- and a STD. to add employee plus any dependents on her medical and dental
Employee's Personnel Office must coordinate the employee's STD. C, HBD- and STD. and his spouse's/domestic partner's HBD- and STD. Spouse's/Domestic Partner's Personnel Office must complete the "Agency Use Only" section of the spouse's/domestic partner's forms and send the forms to the Employee's Personnel Office.
Employee's Personnel Office must complete the "Agency Use Only" section of the employee's forms; receive and review spouse's/domestic partner's forms to ensure that all documents are completed accurately and submit them as a package to SCO. The package should be assembled so that the STD. C is on top.
Examples: - Open Enrollment/Cash Option (New Enrollment)
SITUATION: Open Enrollment, Cash Option for Medical, Maintaining State-Sponsored Dental Insurance, Enrolling In Both a Medical and Dependent Care Reimbursement Account, Spouse/Domestic Partner Is Not a State Employee.
Each example begins with an explanation of the employee's current status, his/her desired FlexElect elections, and the actions required by the employee, his/her spouse or domestic partner, and the Personnel Office.
In all examples, the "employee" is the State employee and is the principal figure in the scenario. The "employee's spouse or domestic partner" in some examples is a State employee or may be employed by private industry.
The information/examples in this manual c level executive list does not reflect every possible type of enrollment/change within FlexElect but hopefully provide a broad range of enrollment and change situations.
Example - Open Enrollment/Cash Option (New Enrollment)
SITUATION: Open Enrollment, Cash Option for Medical and Dental - New Enrollment, Spouse or Domestic Partner Also a State Employee.
Employee is currently enrolled in his own State-sponsored medical and dental insurance plans. Employee's spouse or domestic partner, who is also a State employee, is currently enrolled in her own State-sponsored medical and dental insurance plans. Spouse or domestic partner is not currently covering any dependents.
DESIRED FLEXELECT ELECTIONS
Employee wants to enroll in FlexElect for the Cash Option in lieu of his own State-sponsored medical and dental insurance plan.
ACTION REQUIRED
Employee must complete a STD. C to enroll in the Cash Option. Employee must also complete an HBD- and a STD. to cancel his own medical and dental insurance.
Spouse/Domestic Partner must complete an HBD- and a STD. to add employee plus any dependents on her medical and dental
Employee's Personnel Office must coordinate the employee's STD. C, HBD- and STD. and his spouse's/domestic partner's HBD- and STD. Spouse's/Domestic Partner's Personnel Office must complete the "Agency Use Only" section of the spouse's/domestic partner's forms and send the forms to the Employee's Personnel Office.
Employee's Personnel Office must complete the "Agency Use Only" section of the employee's forms; receive and review spouse's/domestic partner's forms to ensure that all documents are completed accurately and submit them as a package to SCO. The package should be assembled so that the STD. C is on top.
Examples: - Open Enrollment/Cash Option (New Enrollment)
SITUATION: Open Enrollment, Cash Option for Medical, Maintaining State-Sponsored Dental Insurance, Enrolling In Both a Medical and Dependent Care Reimbursement Account, Spouse/Domestic Partner Is Not a State Employee.