Costco

YOU DO NOT NEED TO TAKE ANY ACTION IF YOU ARE NOT MAKING CHANGES FOR 2010, UNLESS YOU WANT TO PARTICIPATE IN THE HEALTH CARE OR DEPENDENT CARE REIMBURSEMENT ACCOUNTS. CLICK HERE TO FIND OUT WHY “FLEXING YOUR EMPLOYER HEALTH BENEFITS” AND PARTICIPATING IN A HEALTH CARE REIMBURSEMENT ACCOUNT CAN BENEFIT YOU.

OPEN ENROLLMENT GUIDE & BENEFIT ENROLLMENT WORKSHEET

A Benefit Enrollment Worksheet and 2010 Annual Open Enrollment Guide was mailed to your home address at the end of October if you were enrolled in a Benefit Plan on 10/09/2009. Any changes processed by the Costco Employee Benefit Department after 10/09/2009 are not reflected on this worksheet.

Employees becoming eligible for benefits on November 1, December 1 and January 1 will also be mailed a Benefit Worksheet. They will use this Benefit Worksheet to complete the enrollment process for newly eligible employees as well as make changes for Annual Open Enrollment such as enrolling in a flexible spending account.

MAKING OPEN ENROLLMENT CHANGES

There are 2 ways to make Annual Open Enrollment elections:

Enrollment Website
Costco Enrollment Center 1-800-541-6205

You’ll need your 6-digit Costco Employee ID Number and your Personal ID Number found on your Benefit Enrollment Worksheet.

If you do not have your Benefit Enrollment Worksheet and have NOT logged on to the enrollment system before your Personal ID Number will be the last 4 digits of your social security number.
You will be prompted to change your Personal ID Number when logging on for the first time. If you have forgotten your password simply click on the “Forgot Your PIN” link located on the Enrollment Website log in page.

WHEN DO CHANGES GO INTO EFFECT?

Most changes for Annual Open Enrollment will go into effect on January 1, 2010. Exceptions are:

Voluntary Short Term Disability – Coverage will take effect on July 1, 2010. For coverage to take effective you must be actively at work on July 1, 2010 and working at least 10 hours a week.

Supplemental Life Insurance – Changes to your Supplemental Life Insurance will go into effect January 1, 2010 unless if you make changes to your Supplemental Life Insurance amounts that require you to complete an Evidence of Insurability application. If an Evidence of Insurability application is needed, one will be sent to your home address in December. Your change in coverage will not go into effect until Unum has reviewed and approved your Evidence of Insurability application.

Additional Forms and Documentation - You may be required to submit additional forms and supporting documentation before your elections can be processed and go into effect. All additional forms and documents must be received in the Benefit Department no later than NOVEMBER 30, 2009. You may submit your documents directly to the Benefit Department in one of the following ways:

by fax to 425/427-3069
by intercompany mail to Costco Benefits Department #99
by U.S. Mail to P.O. Box 34195, Seattle, WA 98214-1195 Attn: Benefits Department

The below forms can be found on the Booklets and Forms page or the Enrollment Website:

Declaration of Domestic Partnership
Declaration of Legal Guardianship
Declaration of Plan Eligibility for Stepchild
Decline Coverage Acknowledgement Form

Questions
You can find answers to any questions you may have regarding the benefit plans and enrollment rules in the Summary Plan Description or by contacting your location’s Payroll Clerk or Benefits representative. You can also contact Costco’s Benefit Department at 1-800-284-4882 or by e-mail to benefits@costco.com.

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