OrthoSynetics, Inc. Medical, Dental, and Vision Insurance On-line Open Enrollment Instructions

OrthoSynetics, Inc. Medical, Dental, and Vision Insurance On-line Open Enrollment Instructions

1. Log onto My Payroll Page (https://oca.ultipro.com). Please disable any pop-up blockers you may have installed on your computer. Go to http://www.orthodon.com/home/document/instructions.pdf for detailed logon instructions. If you are using a mobile device, please click View Desktop Version.

2. First, verify your personal information. Hover over Myself and select Name, Address, and Telephone.

3. If your name, mailing address, e- mail address, and phone number are correct, skip to step 7. If your name has changed, please e- mail or fax a copy of your new Social Security card to your HR Rep (the fax number is 504-832-0156). If your address, phone number, or e-mail address have changed, click edit.

4. Enter your new contact information and click save. Please note that any field with a red dot is required.

5. Click save again.

6. Your request will be sent to the HR department for approval. Your old information will be displayed until HR approves your change; there is no need to resubmit your changes as long as you see the pending transaction message.

7. Hover over Myself and select Open Enrollment.

8. Read the message on the About Open Enrollment page. You can stop at any time by clicking the draft button. Please note that your enrollment is not complete until you have gone through all of the steps and clicked the submit button. You will receive a confirmation of your changes at the end. This confirmation is for your records; please do not send it to HR. 9. Click next to continue.

10. First, you will set up your life insurance beneficiaries and health insurance dependents. To add a beneficiary or dependent, click add.

11. Enter your contact s personal information. Please note that any field with a red dot is required. NOTE: Each beneficiary and dependent must be assigned a relationship code. To see the available codes, (1) click the Search icon (it looks like a magnifying glass) and then (2) click the word Search. If your contact is a beneficiary, you may select any relationship code shown If your contact is a dependent and will be enrolled in any of the health insurance plans, they must qualify (be a spouse or child under the age of 26)and be assigned one of the following three codes: Daughter (DAU) Son (SON) Spouse (SPS) If you select any other code for an insurance dependent, the dependent will NOT be enrolled in the health insurance plan. Click the appropriate relationship code and continue to enter your contact s information. If your contact will be covered by the dental and/or medical insurance plans, click the box next to the word Dependent. Please make sure that your dependent has either the Daughter, Son, or Spouse relationship code. If your contact will be your life insurance beneficiary, click the box next to the word Beneficiary. Your contact can have both codes.

12. Click save once all of the information has been entered.

If you want to add another person as your beneficiary or dependent, click Add and repeat steps 11 and 12. Click a contact s name to view or edit their information. 13. Click next once you ve added and corrected all of your contacts information.

14. Each full-time employee is given a FREE $20,000 life and AD&D insurance policy. Unfortunately, employees are not able to purchase additional insurance. Click the button next to the words Life insurance.

15. Each contact that you ve designated as a beneficiary will be displayed. Click the button next to the beneficiary s name and indicate whether they are the Primary or Secondary beneficiary. Then, indicate the percentage of the policy that each beneficiary will receive. You can add as many beneficiaries as you d like; the total percentage must equal 100%. 16. Click next to continue to the medical plan enrollment.

OrthoSynetics offers employees the option to choose the medical insurance plan that best fits their needs. Please refer to the Open Enrollment memo or go to the Human Resources website http:/www.orthodon.com/home/page/humanresourcescenter to see details regarding the different plans. 17. Click the button next to the name of the medical plan in which you want to enroll. Please note that the rates shown in this guide are not the actual rates and are for demonstrative purposes only. The current rates can be found in the Open Enrollment memo.

18. Select the option in which you d like to enroll. Your choices are: Employee Only, Employee + Child(ren), Employee + Family, or Employee + Spouse. If you choose to enroll family members, each contact that you ve designated as a dependent and belongs to the selected group will be displayed. Click the button next to the names of the dependents that will be enrolled in the dental plan. You can add as many qualified dependents as you d like.

19. If you do not want to enroll in the Medical insurance plan, click the box next to the words I decline Medical plans. 20. If you decline to enroll in the Medical plan, you must give a reason. Click the drop-down arrow and select the option that best fits your reason for declining to participate. 21. Click next to continue to the dental insurance enrollment.

22. If you want to enroll yourself or your eligible family members in the dental insurance plan, click the button next to the words Dental Insurance. Please note that the rates shown in this guide are not the actual rates and are for demonstrative purposes only. The current rates can be found in the Open Enrollment memo.

23. Select the option in which you d like to enroll. Your choices are: Employee Only, Employee + Child(ren), Employee + Family, or Employee + Spouse. If you choose to enroll family members, each contact that you ve designated as a dependent and belongs to the selected group will be displayed. Click the button next to the names of the dependents that will be enrolled in the plan. You can add as many qualified dependents as you d like.

24. If you do not want to enroll in the dental insurance plan, click the box next to the words I decline Dental plans. 25. If you decline the dental plan, you must give a reason. Click the dropdown arrow and select the option that best fits your reason for declining to participate. 26. Click next to continue to the vision insurance enrollment.

27. If you want to enroll yourself or your eligible family members in the vision insurance plan, click the button next to the words Vision Insurance. Please note that the rates shown in this guide are not the actual rates and are for demonstrative purposes only. The current rates can be found in the Open Enrollment memo.

28. Select the option in which you d like to enroll. Your choices are: Employee Only, Employee + Child(ren), Employee + Family, or Employee + Spouse. If you choose to enroll family members, each contact that you ve designated as a dependent and belongs to the selected group will be displayed. Click the button next to the names of the dependents that will be enrolled in the plan. You can add as many qualified dependents as you d like.

29. If you do not want to enroll in the vision insurance plan, click the box next to the words I decline Vision plans. 30. If you decline the vision plan, you must give a reason. Click the dropdown arrow and select the option that best fits your reason for declining to participate. 31. Click next to continue to the Confirm Your Elections or Changes page.

32. Confirm that all of the selections that you ve made are correct. If anything needs to be corrected, click the back button and return to the page that needs to be changed. 33. Once everything is correct, click submit. Your new insurance selections will become effective January 1 st.