Staff members are eligible to enroll for these benefits when assigned to regular positions scheduled to work at least half-time (1,040 hours per year). Full-time faculty members, faculty members contracted to teach four units of course work or meet an equivalent set of responsibilities during the academic year, and visiting faculty members contracted to teach three units of course work in one semester, are eligible for the flexible benefits plan.

Here’s what you need to do within 30 days of your date of hire (or date you move into a benefits-eligible position):

Step A.

Review the 2021 Benefit Guide for a summary of the benefits offered as part of this plan and to determine the benefits that best meet the needs of you and your family in 2021. You may choose from the following benefits:

Step B. 

Review vendor-specific information to help with decision making by clicking on the applicable links above.

Step C. 

Complete the enrollment form(s) available through the links below.  The enrollment/change form is an electronic form that is completed and submitted online.  All benefits-eligible faculty and staff are asked to complete an enrollment/change form regardless if they are electing university benefits or if they are making changes.  Please note that no paper enrollment forms will be accepted.

  • 2021 Benefits Enrollment/Change Form (if it's helpful, there's an optional worksheet linked below to help you think about your elections before you fill out your enrollment form)
  • 2021 Benefits Election Worksheet (use this worksheet to calculate your payroll deductions - includes rates and instructions for calculating supplemental life and AD&D premiums)
  • Affidavit of Marriage or Domestic Partnership Form (required if you are enrolling your spouse, domestic partner and/or domestic partner's child for a benefit for the first time)
  • After-Tax Payroll Authorization Form (required if you are enrolling a domestic partner and/or domestic partner's child for one or more benefits)
  • Beneficiary Designation Form (strongly encouraged for everyone)

Send your applicable form(s) to Human Resources. You can deliver in person to Howarth Hall 016, send through campus mail to CMB #1064, or scan and send via email to, whichever is most convenient for you. Don't forget your signature on each document.

Need help?

Contact Human Resources for help at 253.879.3369 or

If you do not submit your completed forms to Human Resources within 30 days of your date of hire (or appointment to a benefits-eligible position), your 2021 benefit elections will default to enrollment in the high deductible HRA medical plan for yourself only. Your next opportunity to make changes to your benefits will be fall 2021 open enrollment, unless you experience a qualifying status change (e.g., birth or adoption of a child, partner’s loss of employment).

HIPAA Notice of Privacy Practices

View a PDF of The University of Puget Sound Flexible Benefits Program Privacy and Security Policy and Procedures.

COBRA Continuation of Healthcare Coverage

COBRA can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under the plan when they would otherwise lose their group health coverage. For additional information about your rights and obligations under the plan and under federal law, please review this general notice about COBRA, which is also provided in hard copy to all faculty and staff newly eligible for health care benefits. You may also want to evaluate other medical plan options in addition to COBRA, referenced on the ACA website and on this flyer.