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Enrollment & electionsIssued by a provider · Your employer

Employee Benefits Enrollment

The open-enrollment portal where you elect health, retirement, and insurance benefits — often the highest-leverage form you fill out all year.

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Your your employer issues your copy. Use the sample below to read your own, and the official guide to go deeper.

Employee benefits (DOL)

Where it's explained

Sample

Illustrative — for learning, not an official copy

Asel Nurlanovna's workplace benefits-enrollment portal — the screen through which most employees first meet the financial landscape. Header: Meridian Group HR Benefits Center, employee Asel Nurlanovna, annual salary $72,000, open-enrollment closes in 9 days. Section 1, retirement savings: a 401(k) with her contribution set to 3% of pay (about $83 each biweekly paycheck, $2,160 a year) and an employer match of 100% of the first 3%, also $2,160 a year — she is capturing the full match but contributing no more, and the IRS lets her add far more. Section 2, health: a high-deductible medical plan paired with a Health Savings Account she is eligible to open and fund — the only triple-tax-advantaged account. Section 3, insurance: employer-paid group term life and long-term disability. Section 4, also offered through the workplace: supplemental retirement annuity products from a third-party vendor tabling at the benefits fair — offered through work but not vetted as a good deal, and a common channel for high-commission sales. A footer notes this is a sample for learning. The taught elements — the 401(k) match and the HSA — are highlighted.

Meridian Group — HR Benefits Center
New-hire enrollment · Asel Nurlanovna · Salary $72,000/yr
Open enrollment closes in 9 days
SAMPLE — FOR LEARNING
Choose your elections below. These come to you through your job; anything not listed here (an IRA, a taxable brokerage) you open yourself.
1Retirement savings (through payroll)
401(k) — your contribution THIS LESSON
3% of $72,000 = $2,160/yr, taken pre-tax from each biweekly paycheck. The plan's box; you still pick the funds inside.
3% · ~$83/paycheck
Employer match THIS LESSON
Meridian adds 100% of your first 3% — free money, fully captured at 3%. (IRS lets you contribute far more — see Lesson 16.)
+$2,160/yr
Roth 401(k) option
Same account, after-tax flavor — Roth is a tax treatment, not a separate account.
Available
2Health coverage
Medical plan
A high-deductible health plan — the kind that unlocks an HSA.
HDHP selected
Health Savings Account (HSA) THIS LESSON
The only triple-tax-advantaged account: deductible going in, grows untaxed, tax-free out for medical costs.
Eligible to open
Dental / vision
Elected
3Insurance (employer-provided)
Group term life
1× salary · paid by employer
Long-term disability
60% of salary · paid by employer
4Also offered at the benefits fair
Supplemental retirement annuity
Offered through your workplace, but NOT vetted by your employer as a good deal — a common channel for high-commission products. Check how the rep is paid before signing.
3rd-party vendor
Elections lock when open enrollment closes.ReviewSave elections
Sample for learning. Meridian Group, Asel Nurlanovna, and these elections are invented and refer to no real employer, person, or plan. A real benefits portal will show your own employer's plan, match formula, and options.
Asel's workplace benefits portal — where most people first meet the landscape. The 401(k) match (free money, captured) and the HSA are highlighted; note the annuity vendor that's offered through work but isn't vetted for you.