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Enrolling in any of the plans is simple. Once you have reviewed all of the information for each plan, which is found under the appropriate benefit offered on this website such as medical, dental, vision or life, simply follow the Bentrac Online Enrollment Instructions below in order to enroll or waive coverage.
Benetrac Online Enrollment Instructions
Benetrac Online Enrollment Instructions
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The Benetrac Online Enrollment Instructions can be used for enrolling in the medical, dental, vision and life plans and for making changes once you are enrolled.
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2022 Payroll Deduction Authorization
Payroll Deduction Authorization Form
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In order to view the per-pay-period deduction amounts for the medical, dental and vision plans, please click on the Payroll Deduction Authorization Form to the left. If you choose to enroll in any of the plans, please print, complete and sign the form and submit to Human Resources.
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2022 Benefit Highlight Brochure
Benefit Highlight Brochure
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In order to view a summary of the medical, dental, vision and life benefits offered, please click on the Benefit Highlight Brochure to the left.
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Changing Your Enrollment
Once you have made your benefit plan decisions, you cannot change your enrollment until open enrollment for the following benefit plan year, unless you experience a qualifying (life) event, such as marriage, divorce, birth of a child, adoption of a child or placement for adoption. If you experience a qualifying event and wish to make a change to your enrollment by adding or deleting coverage, the change must occur within 30 days of the date of the qualifying event.
If you have experienced a qualifying event, log in to Benetrac in order to make a change to your enrollment.
If you have experienced a qualifying event, log in to Benetrac in order to make a change to your enrollment.
Questions?
For questions about claims, please click on Important Plan/Contract Information under the appropriate line of coverage for the customer service contact number.
For questions regarding plan eligibility, benefits or enrollment forms, contact Thomas Lambert at Ashbrook Clevidence.
Phone: (714) 979-4023
Fax: (714) 979-2809
Email: TomL@aclevidence.com
We thank you for the opportunity to be of service to you and your family!
For questions regarding plan eligibility, benefits or enrollment forms, contact Thomas Lambert at Ashbrook Clevidence.
Phone: (714) 979-4023
Fax: (714) 979-2809
Email: TomL@aclevidence.com
We thank you for the opportunity to be of service to you and your family!
