Open Enrollment - May 2021

The month of May is Pekin 108's open enrollment month. Employees are able to make changes to insurance coverage, enroll in our flexible spending plan or other benefits, or terminate coverage during this time. At other times throughout the year, employees may make changes with a qualifying life event. All applicable forms and the related information is available through this page. Please contact Caty Campbell in the Business Office at if you have any questions.

You can return your forms to the Business Office by mail (501 Washington St, Pekin IL 61554), dropoff or by email. 

All changes made during the open enrollment period became effective on July 1, 2021 and will remain in effect until June 30, 2022 unless you notify the Business Office of a qualifying event. Qualifying event changes will be determined on a case-by-case basis.

Overview of Employee Benefits

Health, Dental and Vision Insurance

If you want to enroll or add dependents to your BCBS (medical and dental) or VSP vision insurance, please complete the appropriate enrollment form and return to the Business Office. 

BCBS Enrollment Form

VSP Enrollment Form

If you want to terminate coverage or remove dependents from your BCBS or vision insurance, please send me an email notifying me of the requested change.


BCBS Plan Information



VSP Vision Plan Information

Schedule of Benefits

Eyeconic Flyer


Flex Spending for Medical Expenses or Dependent Care

If you want to enroll in the flexible spending plan for medical reimbursement or dependent care, please complete the Group Plan Solutions (GPS) enrollment form. If you do not return this form, you will not be enrolled in the flex spending plan for 2021-2022.

GPS FSA Enrollment Form


If you choose to enroll in the flex spending plan, you may find these flyers and forms helpful as well.

Flex Spending Info and Important Dates

GPS FSA Online Account Instructions

GPS Direct Deposit Form


Flexible Spending Medical Expenses

Medical Expense Claim Form

Medical Reimbursement Claim Form

Medical Expense Debit Card Info


Flexible Spending Dependent Care Expenses

Dependent Care Claim Form

Other Voluntary Options

Colonial Life Voluntary Insurance

Colonial Life offers other types of voluntary coverage, such as accident, cancer and life insurance. See contact information on the flyer below.

Colonial Life Flyer


IMRF Voluntary Additional Contribution Program

This program allows for IMRF contributors to put aside funds to be used for retirement or other purposes.  Funds are deducted through payroll after taxes and then held by IMRF.  Interest is credited to your account only once a year; however, funds put into this program are currently being paid interest at 7.25% (effective 1/1/2019).  You can elect to contribute up to 10% of your earnings. This is not to be seen as a short-term savings account as you can withdraw your contributions, but you must apply for a refund of all of your contributions when you do.  These funds can be applied to your monthly retirement annuity if your balance in the VAC program at the time of retirement is at least $4,500. You can enroll in the program or make changes to your contributions at any time by completing the IMRF VAC form below.



Additional information can be found on the IMRF website here: