Open Enrollment
Open Enrollment 2012 is from October 3 to October 31. Forms and information for Seattle Housing Authority employees and their dependents can be be found on this page. If you have more questions that can't be answered on this page, contact Maria Sahagun at 206-615-3328, or by email at msahagun@seattlehousing.org.
Open Enrollment Information
Annual Notices
Open Enrollment Guides
Other Information
Open Enrollment Forms
- 2012 Benefits Election Form
- Affidavit of Marriage / Domestic Partnership Form
- Medical History Statement - Must be completed if enrolling or increasing life insurance. Please contact Maria Sahagun at 206-615-3328 for this form.
- Long Term Care Evidence of Insurability - Must be completed if enrolling or increasing Long Term Care coverage. Please contact Maria Sahagun at 206-615-3328 for this form.
Flexible Spending Plan Forms
- Flexible Spending Plan Open Enrollment Kit
- Flex Plan Enrollment Form for 2012
- Flex Plan Reimbursement Claim Form (for 2012)
- Flex Plan Reimbursement Claim Form (for 2011)
- Frequently asked questions about Benny Card
Wellness Tools
Aetna Tools
- Aetna Wellness Tools
- Simple Steps to a Healthier Life
- Personal Health Record Example
- Informed Health Line
- Informed Health Line Wallet Card
Group Health Tools
Health Risk Assessment Comparisons
Flu Shots Schedule
- Seasonal Flu Shot Consent Form
- September 30, – (9:30 a.m. – 11:30 a.m.) – Central Office, Board Room, 120 6th Ave N.
- October 4, – (7:00 a.m. – 8:00 a.m.) – MLK Maintenance Facility, 810 MLK Jr. Way S.
- October 5, – (7:00 a.m. – 8:30 a.m. ) – OSC Facility, 1300 N 130th St.
- October 10, - (9:30 a.m. – 10:30 a.m.) – PorchLight Community Rm., 907 NW Ballard Way
Please Note: Group Health nurses will administer all flu shots. Aetna will be billed for Preventive member shots. The vaccination will be a mix of seasonal and H1N1 vaccine. Costs are as follows:
Employees covered by the Aetna Preventive, Group Health Standard and Group Health Deductible (through the City/SHA) are fully covered and will have no fee for the flu shots – please be sure to bring your medical ID card for your free flu shot.
Employees covered by Aetna Traditional will have a $28.00 fee (check or money order only, cash not accepted) for the flu shot at the time of service.
Employees covered with another employer or who has additional insurance (including secondary insurance through a spouse/partner) may be eligible for full or partial reimbursement from their secondary providers; please check with your secondary insurance provider directly if they will reimburse your flu shots. You will need to pay $28.00 by check only at the time of service.
City and Seattle Housing Benefits Fairs Schedule
- Wednesday, October 6, 2010 City Hall– Bertha Landes Conference Rm., 600 4th Avenue, Seattle, WA 98104 9:30 a.m.—2:30 p.m.
- Tuesday, October 12, 2010 Rainier Community Center—Gym, 4600 38th Avenue South, Seattle, WA 98118 7:30 a.m.—10:30 a.m.
- Thursday, October 14, 2010 Bitter Lake Community Center—Gym, 13035 Linden Avenue North, Seattle, WA 98133 7:30 a.m.—10:30 a.m.
