Opting into medical insurance includes the following forms of coverage:
- Medical (with Medical Mutual)
- Prescription (with CVS Health)
- Dental (with Delta Dental)
- Vision (with EyeMed)
Relevant Forms
| Form | What is it? | Is it required? | Due Date |
|---|---|---|---|
| New Hire Portal Instructions (PDF) | Use the Portal Instructions to set up your Benefits portal. From there, select/enroll in your medical (which includes prescription and vision coverage) and dental insurance. | YES | 31 Days after your hire date |
| Opt-Out Affidavit (PDF) | Use this form if you would like to opt out of insurance provided by Kent State. Note, you will need to provide evidence of alternative coverage. | Optional | 31 Days after your hire date |
| Domestic Partner Affidavit (PDF) and supplemental documentation (if applicable) | If you have a domestic partnership and would like to cover your partner, use this form and guidelines. | Optional | 31 Days after your hire date |
| COBRA Acknowledgement Form (PDF) | This is an acknowledgment that if you leave the university, COBRA information will automatically be offered to you. This form does not automatically sign you up for COBRA. | YES | 31 Days after your hire date |
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