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Info
titleHow 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. 

...

  • 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. 

Warning

We understand that secure information is being collected. All data is transmitted with end-to-end encryption through DocuSign SignNow and retained on secure Reliant servers. The information will only be shared with our insurance carriers when necessary.


UI Steps
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UI Step

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


UI Step

Locate your digital paperwork envelope in an email from DocuSign and click the link to open the envelope in a web browser.

UI Step

You will then need to authorize DocuSign to collect your signature digitally. Check the box and select continue.

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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

UI Step

Press continue and fill out all required fields.  DocuSign will guide you only to the forms you are required to submit.  Red boxes indicate required information cells. If there is no red box, then the information is not required.


UI Step

Complete the Form

Begin filling out the required fields on the document.

Make sure to use your full legal name!

We have provided copies of the forms and descriptions below on this page.  Please look at the drop downs below anytime you are uncertain about what is being asked on the specific form. 

Please follow these guidelines for filling out all forms: 

  • Read each text box carefully to ensure you type in the correct information.
    • Please manually type in the information. Pre-filling or auto-filling may cause the form to fill incorrectly. 

    UI Step

    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.


    UI Step

    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.

    Sign and Submit the forms using the green box at the end.

    Note

    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.



    UI Step

    Download a Copy (if you want to)

    To make sure that you submitted the form doesn't close, it will redirect you to cells where information is missing. , 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.


    UI Expand
    titleAetna Enrollment/Change Request Form

    UI Expand
    titleEnrolling in New Coverage


    Before continuing...
    UI Steps


    Note

    Please Select from the Dropdown "I am Enrolling Myself (and any applicable dependents) in New Coverage"

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    UI Step

    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.


    UI Step

    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: input in Day, Month, Year format (example: 1 January 2023)make sure to select the month, day, and correct year for your birth day
    • Male / Female: select whichever applies to you
    • Social Security Number

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    UI Step

    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

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    Resident Location

    This is the country or location where you are physically present for at least half of a one-year period.

    Note

    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

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    UI Step

    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

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    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.

    Note

    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

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    UI Step

    Dependents

    Here is where you can add dependents if desired.

    title are NOT adding dependents, please no"
    Expand
    titleIf you are adding dependents, please select "yes"

    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

    Image RemovedImage Added

    Expand
    Note

    If you select "No," then no dependent fields will populate.

    If you

    select "

    Yes," then fields will populate to add dependent information.

    Image Added

    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

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    Nothing more needs to be done. You can move on to the next section

    .




    UI Step

    Signatures

    Sign the document, and adopt the signature if needed.

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    Then click "Finish" to submit your form.

    Warning

    If you miss anything, the form will require you to complete the red boxes before you can select "finish."


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    Tip

    If you see the option to download and print your form, then your form is submitted!

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    You can select "Get my Document Copy" to get a copy of your submitted form.

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    UI Expand
    titleChanging covered dependentsAdding Dependents to your Existing Plan


    UI Steps


    Before continuing...

    Note

    Please Select from the Dropdown "I am keeping my current coverage but Adding or Removing Dependents"

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    UI Step

    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.


    UI Step

    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

    Image Added

    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.Image Removed


    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.


    UI Step

    Dependents

    Please select whether you are adding new dependents or removing current dependents. 

    Image Removed

    Since you selected the Add Depenents form, the option "Yes" to adding dependents has been pre-selected.

    Note

    If you would like to do both, for example, add one dependent and drop a different dependentadd 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

    Image Added

    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.Image Removed


    UI Step

    Signatures

    Sign the document, and adopt the signature if needed.

    Image Added

    Then click "Finish" to submit your form.

    Warning

    If you miss anything, the form will require you to complete the red boxes before you can select "finish."

    Image Added


    Tip

    If you see the option to download and print your form, then your form is submitted!

    Image Added

    You can select "Get my Document Copy" to get a copy of your submitted form.

    Image Added





    UI Expand
    titleRemoving Dependents from an existing plan


    UI Steps
    UI Step

     Certification and Waiver Section

    Fill out your full legal name and the last four digits of your social security number.

    Image Added

    UI Step

    Select Dependent Waiver Option

    Please select whether you want to waive all eligible dependents (including your spouse if applicable), or only specific dependents:

    Image Added

    UI Expand
    titleAll Eligible Dependents

    This will waive all of your dependents, including spouse and children, and change your plan to an Employee Only plan. 

    If you select this option, no fields will populate.

    UI Expand
    titleOnly these 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:

    Image Added

    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.


    UI Step

    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.

    UI Step

    Sign and Submit the Document

    Sign the document, and you should see a green banner appear with a box that says "Finish."

    Image Added

    Then click "Finish" to submit your form.

    Warning

    If you miss anything, the form will require you to complete the red boxes before you can select "finish."

    Image Removed

    Image Added


    Tip

    If you see the option to download and print your form, then your form is submitted!

    Image Added

    You can select "Get my Document Copy" to get a copy of your submitted form.

    Image AddedImage Removed




    UI Expand
    titleVoluntary Life Enrollment Form

    After you have determined you want coverage for yourself, your spouse, and/or your child(ren), please follow the instructions on the 2025 International Open Enrollment Solomon page.

    • Completing this form will help the Benefits Team determine if the coverage you are requesting is over the Guaranteed Issue amount; if it is, you will be sent instructions on going through the underwriting process with RSLI by completing an RSLI power form.
    • If you request coverage for yourself and/or your spouse over the Guaranteed Issue amount, you must complete an RSLI power form. 
    • To be eligible for child(ren) voluntary life coverage, you and/or your spouse must carry double the amount of child(ren) coverage requested. 
    • See 2025 Open Enrollment Voluntary Life Insurance and Group Life and Voluntary Life Insurance for more information and details about coverage.


    ...