ACT

Sign Up for Coverage

Sign up for 2024 Medical, Dental or Vision Coverage Decide who will be covered. If needed, provide Marriage License and/or Child(ren) Birth Certificate(s).	Complete a benefit enrollment form.
Waive your Price Rite benefits.	Select the waiver option on the benefit enrollment form.
Short Term Disability Benefits (STD)	Complete the STD enrollment form.
Long Term Disability Benefits (LTD) - How do you want to receive your benefit?	Complete the LTD enrollment form.
Basic Life Insurance	Complete the basic life insurance enrollment form.
Optional Life Insurance	Complete the optional life insurance enrollment form.

Complete the LTD enrollment form.

Complete the LTD enrollment form.

Check out these helpful tools and resources

Enrollment Guide: Download this detailed guide and learn more about specific benefits and services.
Frequently Asked Questions: Answers to the most frequently asked questions about Open Enrollment.
Important Terms: Commonly used benefit terms and what they mean.
Legal Notices: Your rights as a consumer.

Sample text. Click to select the Text Element.

Summary of Benefits and Coverage: How the plan would share the cost for coverage services. Download a 2024 SBC here: