Open Enrollment

Enrollment Forms

Below, you'll find links to printer-friendly enrollment forms (PDF format) for the 2012-13 plan year.

Open Enrollment Forms

  1. Health/Dental/Vision benefits form
  2. Life and AD&D insurance form
  3. Flexible spending accounts form

Retiree Open Enrollment Forms

  1. Retiree Health/Dental/Vision benefits form

Form Pickup Locations

Printed forms are available for pick up at 112 Scovell Hall.

University of Kentucky - An Equal Opportunity University
Human Resources · 115 Scovell Hall · Lexington, KY 40506-0064
Phone: (859) 257-9555 · Fax: (859) 323-8512
Questions/Feedback: HR | HR Site
About Human Resources
Last Modified: March 4, 2011 | Off-site Link Disclaimer