Participating employers are asked to select one option from each group: Employee Only, Employee Plus 1 / Employee Plus Child(ren), and Family. Options for each group, along with explanations regarding how these cost tiers were developed, are outlined in this reference document.

Fill out one form per legal entity; parishes with schools must make the same contribution elections for both (under the Parish Corp ID). Note: as the cost for Employee Plus 1 and Employee Plus Child(ren) are the same, this year participating employers will select one contribution amount that will apply to both groups.

Please complete the 2020 Contribution Election Form below and submit by Friday, August 23.