How to Prepare for Open Enrollment
- Reminder, you only need to submit an Open Enrollment Form if you are making changes effective January 1, 2025.
- Read the details on what's new in the 2025 International Open Enrollment section so that you know your enrollment choices for International Insurance and optional Voluntary Life Insurance.
- Be sure to have Social Security Number (SSN) for each member of your family on hand
- Review the options on these pages to determine what coverage you would like to elect for 2025:
- If you qualify for a Reliant-approved waiver and wish to continue waiving, prepare a photo of your insurance documents that can be attached to your enrollment form.
For Families with Multiple Employees
Reliant wants you to choose the coverage that is most advantageous for your family.
- Each employee will complete their form individually unless your family chooses "Family" or "Employee + Spouse", then one employee will be considered primary, and the other is listed as a dependent on the insurance plan.
If you and your spouse are each choosing Employee Only plans, then do not add your spouse as a dependent. Only add your spouse or children as dependents if they are part of your plan.
- Please note and consider the premium difference between selecting 2 individual plans and selecting the "Employee +Spouse" plan.
- Options exist where each employee might be the primary insured subscriber.
- These coverage and structure choices can be changed during Open Enrollment and during qualifying events (births, deaths, adoptions, etc.)
- If a family changes the primary insured, then all family members need to be entered on appropriate forms as if they are enrolled for the first time.
Guide to Filling out the Aetna SignNow Form
This year, Reliant is utilizing a secure website to send and sign paperwork for International Open Enrollment. See the steps below for details about how to fill out the forms.
We understand that secure information is being collected. All data is transmitted with end-to-end encryption through SignNow and retained on secure Reliant servers. The information will only be shared with our insurance carriers when necessary.
Gather Information
Gather the below information for all covered individuals that you may need to complete the form
- Legal Name - Name on the social security card
- Social Security Numbers
- Countries of citizenship and residence
- Gender
- Birthdate
- Mailing address - Both international and stateside, as applicable
- E-mail address
- Phone number
- Images of the front and back of your insurance card if you need to renew a Reliant and supervisor-approved waive
Select your Forms
Go to 2025 International Open Enrollment and determine whether you want to CHANGE your current plan or ENROLL in a new plan.
Select the button that first what you want to do. (Enroll in new coverage, add dependents to your existing plan, or remove dependents from your existing plan.)
Click that button will open the SignNow documents.
Complete the Form
Begin filling out the required fields on the document.
Make sure to use your full legal name!
Sign the Document
The first time you select "Sign" on the form, you will need to select a signature design. You can choose one of their fonts or draw your own.
Submit the Form
When you've finished filling out all the required fields and signing the document, a green banner should appear at the bottom of your screen with a button that says "Finish" or "Finish and Send." Click that button and wait for the next page to be sure that your document has been submitted.
You should see a fairly blank page with a note that says "Document Signed" on the left side of the screen.
By signing and submitting these forms, you are verifying that all information is correct to the best of your knowledge according to your current situation and allowing Reliant to process any benefits changes according to the information on these forms.
If you don't see the green banner, there are still required fields to complete.
Download a Copy (if you want to)
To make sure that you submitted the form, you will be on a screen that allows you to download a copy of your submitted forms.
This is optional, but recommended.
You can choose to either send a copy to your email, or you can download the copy directly to your computer.
It doesn't matter if you download a copy or not-- once you've reached this page, the form has been submitted to Reliant for processing.
Section 1: Policy / Plan Details
This section is to be done by Reliant office staff. Nothing needs to be completed by you at this time.
Section 2: Employee Details
Covered Member Details
This is where you (the field staff member) will fill out your personal details. The boxes outlined in red are required and will not let you move forward without completing them.
- Last Name: full legal last name
- First Name: full legal first name
- MI: middle initial (optional)
- Date of Birth: make sure to select the month, day, and correct year for your birth day
- Male / Female: select whichever applies to you
- Social Security Number
Section 3: Contact Details
Employee Mailing Address
Please input the address where you would like to receive mail.
- Email address: this can be your reliant.org email address or another email address you have access to
- Telephone Number
- Country
- Mailing Address line 1
- Mailing Address line 2 (optional)
- Mailing Address line 3 (optional)
- City
- State / Province (if outside of the US)
- Zip Code
Resident Location
This is the country or location where you are physically present for at least half of a one-year period.
If your Resident Location is the same as your mailing address, you can check the box that says "Check If same as the mailing address."
This will eliminate the boxes, and we will use your mailing address information for your resident location.
If it's not the same as your mailing address, fill out the sections below:
- Country
- Mailing Address line 1
- Mailing Address line 2 (optional)
- Mailing Address line 3 (optional)
- City
- State / Province (if outside of the US)
- Zip Code
Section 4: Additional Information
Citizenship
Please input your primary country of citizenship.
You can add two additional citizenships if desired. If you have more than 2 additional citizenships, please email benefits@reliant.org
Home/origin location
This is the location where the employee resided prior to their assignment and maintains a residence to return to during or following their assignment.
If your Home/origin Location is the same as your mailing address, you can check the box that says "Check If same as the mailing address."
This will eliminate the boxes, and we will use your mailing address country, city and state for your home/origin location.
- Country
- City
- State / Province
Dependents
Here is where you can add dependents if desired.
Boxes will appear, and you can add your dependents. You can add up to seven dependents. If you need more than seven, please email benefits@reliant.org to get them added to your insurance plan.
- Dependent's Full Legal Name
- Dependent's Relationship to you (husband, spouse, daughter, son)
- Dependent's Birth date
- Dependent's Primary Country of Citizenship
If you select "No," then no dependent fields will populate.
If you select "Yes," then fields will populate to add dependent information.
One dependent will be required, and if you add more dependents, once you complete the first line, the rest of the line will be required.
Signatures
Sign the document, and adopt the signature if needed.
Then click "Finish" to submit your form.
If you miss anything, the form will require you to complete the red boxes before you can select "finish."
If you see the option to download and print your form, then your form is submitted!
You can select "Get my Document Copy" to get a copy of your submitted form.
Section 1: Policy / Plan Details
This section is to be done by Reliant office staff. Nothing needs to be completed by you at this time.
Section 2: Employee Details
Covered Member Details
This is where you (the field staff member) will fill out your personal details. The boxes outlined in red are required and will not let you move forward without completing them.
- Last Name: full legal last name
- First Name: full legal first name
- Middle initial: optional
- Date of birth: make sure to select the correct month, day and year. It will automatically change it to the correct format
Additional information will not be needed since your information is already in Aetna.
If you need to make changes to other information like your mailing address or resident address, please complete the Contact Info Change Form - International.
Sections 3 and 4 will not be required since you are a covered employee already under Aetna's group plan.
If you are not covered by Aetna, please use the new enrollment form.
Dependents
Since you selected the Add Depenents form, the option "Yes" to adding dependents has been pre-selected.
If you would like to add dependents and remove dependents at the same time, please contact benefits@reliant.org.
You can add or remove up to seven dependents.
- Dependent's full legal name
- Dependent's relationship to you
- Dependent's birth date
- Dependent's social security number
- Dependent's country of citizenship
Once you start typing on any of the optional fields, the rest of the line will populate and become mandatory fields to complete. Make sure you have all of your dependents' information.
If you are married and your spouse needs coverage, your spouse is considered a dependent for insurance.
Signatures
Sign the document, and adopt the signature if needed.
Then click "Finish" to submit your form.
If you miss anything, the form will require you to complete the red boxes before you can select "finish."
If you see the option to download and print your form, then your form is submitted!
You can select "Get my Document Copy" to get a copy of your submitted form.
Certification and Waiver Section
Fill out your full legal name and the last four digits of your social security number.
Select Dependent Waiver Option
Please select whether you want to waive all eligible dependents (including your spouse if applicable), or only specific dependents:
This gives you the option of waiving only specific dependents.
If you select this option, you will need to fill out the dependent information:
If you need to waive more than three dependents, please email benefits@reliant.org with all the dependent information for whom you want to waive.
Ignore Dental Coverage section
Dental insurance is included in your Aetna coverage, so this dependent waiver applies to your dependents' dental coverage as well.
This is technically another company's waiver form, but we have authorization from Aetna to use it as the Aetna waiver form as well, which is why there may be different logos and information on it.
Sign and Submit the Document
Sign the document, and you should see a green banner appear with a box that says "Finish."
Then click "Finish" to submit your form.
If you miss anything, the form will require you to complete the red boxes before you can select "finish."
If you see the option to download and print your form, then your form is submitted!
You can select "Get my Document Copy" to get a copy of your submitted form.
Questions?
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