2022 Open Enrollment 
Central Peninsula Hospital
May 16 - June 10

During this time benefit eligible employees have the opportunity to evaluate their insurance needs and make changes to benefits for the following plan year. In order to help you make informed decisions about your benefit options, we are providing all open enrollment materials including educational materials, the open enrollment packet, and forms needed to make any changes available to you electronically through this page. Materials are also available outside the Human Resources Department. 

Enrollment Presentation

Enrollment Booklet
Enrollment Presentation
Enrollment Presentation

Health Plan

If you are making any changes to your health insurance elections, select and fill out the appropriate forms:

To complete the forms, first download and fill in your information.  Signatures can be added by clicking the “Sign” icon at the top of the page.

Completed forms may be saved and emailed to srandall@cpgh.org or printed and dropped off in HR.  Paper copies of forms are available outside the HR Department.

Moda Fillable Enrollment
Health Savings Acct Fillable
Health Reimbursememt Fillable
Decline Benefit Form


As always, you can access your Voya Retirement account at  www.voyaretirementplans.com  and make contribution changes at any time during the year.  CPH does offer employer matching and discretionary contributions, in order to receive them you must be full or part time, have completed 1 year of service in which you worked 1000 hours, and you must be 21 years of age.  Eligible employees receive an automatic 2% discretionary contribution base on the employee’s annual salary.  CPH will match the employee contributions up to a maximum of 3% of employee’s salary.

If you have never enrolled in Voya, you can do so by following the directions provided on the Enrollment Flyer.   Once you have enrolled, you can make changes to your retirement plan contributions by logging onto their website.  You can also manage your investments, take loans, and access the educational pieces and tools that Voya offers. 

Who do I contact for more information?
Voya App
Beneficiary Options
Roth 403(b) Option

Flexible Spending Account

You do not need to be enrolled in the medical plan to take advantage of the FSA!  
With an FSA, you can set aside money from your paycheck before the government takes out taxes (usually 30% or more) to pay for healthcare and dependent child care expenses. You pay less in taxes and your money buys more! While you should only set aside enough money for those expenses you know you will incur during the plan year, the roll-over provision allows you to carry forward up to $500 into the next plan year for your healthcare FSA. 


In 2022, employees can set aside up to $2,750 in pre-tax money for eligible health care expenses and up to $5,000 for dependent care expenses.


Don’t Forget – If you want to participate in the FSA you must re-enroll every year!

FSA Autopay Q & A
Eligible and Ineligible Expenses
Fillable Enrollment Form

Short & Long Term Disability

CPH provides employees with employer paid Short-term Disability, optional additional employee paid Short-term Disability, and optional employer and employee paid Long-term Disability income benefits. In the event you become disabled from a non work-related injury or sickness, disability income benefits are provided as a source of income. You are not eligible to receive short-term disability benefits if you are receiving PTO, IAP, or workers’ compensation benefits.


To enroll complete the Evidence of Insurability Forms and return them to HR.

Short Term Booklet
Short Term Fillable Form
Long Term Booklet
Long Term Fillable Form

Life Insurance

Full-time and part-time employees are eligible to participate in the Life and AD&D insurance plan administered by Cigna. This benefit pays in the event of your death or the death of an eligible dependent. The plan also pays a benefit if you or an eligible dependent loses a limb, vision, speech, and hearing or dies due to an accident.

CPH pays the FULL COST to provide you with life and AD&D coverage equal to one times your annual pay if you are a full or part time employee.

During open enrollment you have the option of purchasing additional coverage for yourself or dependents.

Optional Life and AD&D Insurance

  •  Employee Life: Optional life and AD&D insurance are available if you want more insurance than what CPH provides. Employees may elect coverage in $10,000 increments to a maximum of $700,000 or 7 times your annual salary, whichever is less. The Employee Guarantee Issue, at the time of initial enrollment is $80,000. If you choose coverage beyond that you will be required to provide satisfactory evidence of good health. The amount of your benefit is reduced by 35% at age 65 and 50% at age 70.
  • Spouse Life: You may choose to elect life and AD&D coverage for your spouse in increments of $5,000.  The Spouse Guarantee Issue at the time of initial enrollment is $25,000. If you  choose  coverage  beyond  that  you  will  be  required  to  provide satisfactory evidence of good health.
  • Child/Children Life: You may choose to elect life and AD&D coverage for your child or children amounts of $1,000, $5,000 or $10,000 per eligible child.


To purchase additional coverage, complete the appropriate form below.

Life Insurance Booklet
Life Insurance Change Form
Beneficiary Change Form