2022 Open Enrollment

2022 Open Enrollment

Quick Start Links

  • Click Here for the 2022 Rate Sheet 
  • Click Here for the 2022 Insurance Enrollment Form
    • No changes? All participants need complete the 2022 Insurance Enrollment Form this year, even if you have no changes. Simply fill in Parts 1 and 2 of the form, and mark "No Change" in the top, right-hand corner.​
    • Want to make changes? Use the 2022 Insurance Enrollment Form to change plans, add/remove dependents, change your address, etc.
    • Want to cancel? Complete Parts 1 and 2 of the 2022 Insurance Enrollment Form, and mark "Waive Coverage" in Part 3 and "Refuse" in Part 8. If you are 3/4 or full-time clergy, you must also submit a Waiver of Participation Form. If you mark "Waive Coverage" on your enrollment form, your insurance coverage will terminate at midnight on 12/31/2021.
    • Please complete, save, and email the completed form to openenrollment@holston.org or mail to Holston  Conference, Attn: Open Enrollment, P.O. Box 850, Alcoa, TN, 37701 before November 15, 2021.
    • Want to enroll in a Flexible Spending Account? You do not have to complete a separate form for your Flexible Spending Account (PBS Benny Card) this year. You may make your FSA elections in Part 4 of The 2022 Insurance Enrollment Form.
  • New Prescription Drug Card In 2022! Our Prescription Plan will be administered through EpiphanyRX in 2022. This means you will have two insurance cards in 2022: one for Medical/Dental/Vision coverage from Blue Cross Blue Shield of Tennessee and one from EpiphanyRX for your prescription drugs. Be sure that you give your pharmacist your new EpiphanyRX card beginning January 1, 2022. Click here for a FAQ document about the new Prescription Plan. 

Things to Remember