Benefits Enrollment
Learn more information about HACC's benefits as well as how to enroll.
Benefits Overview
Plan Costs
Comparing the Plans
- Plan Summaries
Benefits Enrollment
- Benefits Enrollment System (Streamlink)
YOUR PASSWORD IS THE LAST FOUR DIGITS OF YOU SSN. - My Benefit Wallet (to activate your HSA Account)
- 2020 Benefits Enrollment guide (pdf)
Required Forms
After you complete your enrollment, be sure to complete and submit all required forms to:
Office of Human Resources
TL205
- Spousal Surcharge Form (pdf)
- Complete this form every year if you are covering your spouse on your medical plan.
- Medical Cash Opt-Out Form (pdf)
- Complete this form every year and submit proof of other coverage if you are waiving HACC's medical coverage. You will not receive the $1,500 waiver until both the form and proof of other coverage are received.
- Dependent Verification (pdf)
- Complete if adding a new dependent to your coverage.
- Evidence of Insurability Form (pdf)
- Complete this form only if you are increasing your coverage or enrolling in Voluntary Life or AD&D for the first time.
Contact Human Resources
AskHR@hacc.edu
717-736-4124