Instructions for the InRoll Online Enrollment System

In order to begin your benefits enrollment, please proceed to www.in-roll.com. Your User Name will be your first initial followed by your last name and the last four digits of your Social Security Number (SS#). The Password will be the word “password”.

Example: Example Login for Beverly Jones User Name: bjones1234 (1234 represents the last 4digits of your SS#) Password: password

After your initial login you will be prompted to change your password. Your new password must be at least five characters and contain at least one number.

Old Password is the word “password”

Please read carefully

before proceeding.

Click here to begin your benefits enrollment.

NAME ADDRESS CITY, STATE, ZIP CODE

Verify your information is correct, if so, click

“Continue”.

Click here to enter or

update your email address

Enter or update your email

address here

Once you have entered your

email address click “Submit

Information”.

When adding dependents for the first time, you

must also submit the required documentation to

the Human Resources Department. The addition

of dependents is not official until HR receives the

documentation.

If you are adding multiple dependents,

you will be redirected to this page after

adding each one. You must add each

dependent separately. Click “Continue

Enrollment” when finished or to continue

if not adding dependents.

If you are planning to add ANY eligible dependents to ANY of

your benefits you MUST enter their information here before

proceeding. Not entering them here will prohibit you from

adding them to ANY coverage later on in this enrollment.

Click here to add dependent information: Dates of birth & social security #’s are required.

Fields in RED

are required.

This will be the same

page if you are adding

multiple dependents.

From this point you will proceed through each benefit option selecting to either take part or decline each coverage type. There will be instructions located at the top of each page as well as links to specific plan information for each type of coverage. If you have to log out during the enrollment, you will not have to re-do any part that has already been completed.

Re-enroll or select a

new plan or waive

medical benefits.

Please click “Submit and Continue”

Re-enroll or select

a new plan or

waive medical

benefits.

Re-enroll or select a new

plan or waive medical

benefits.

$3.36 $5.38 $5.38 $8.74

You must either elect coverage

by entering dollar amounts in

the spaces, or waive coverage

by clicking on the check box.

You must do either one for

EACH of the options.

Please read and acknowledge.

Please click “Submit and Continue”

If you are entering more

than one (1) person as a

beneficiary (either

primary or contingent)

the cumulative “% Share”

must equal “100”.

If applying for supplemental life insurance (SLI)

for the first time or want to increase your SLI

amount you will need to complete and submit an

EOI before approval can be granted for life

insurance. Payroll deductions for any amount

where EOI is required will begin when/if the EOI

request is approved.

Please notice the

14 and 30 day

options.

Please either select a Benefit

and click “I AGREE…”, or do

not select a Benefit and click “I

do not…”

Please either select benefit

and click “I AGREE…”, or do

not select a Benefit and click “I

do not…”

If applying for Short Term Disability (STD)

for the first time you will need to complete

and submit an EOI before approval can be

granted for life insurance. Payroll

deductions for any amount where EOI is

required will begin when/if the EOI request

is approved.

If applying for Long Term Disability (LTD)

for the first time you will need to

complete and submit an EOI before

approval can be granted for life

insurance. Payroll deductions for

any amount where EOI is required

will begin when/if the EOI request is

approved.

Please read plan requirements

before enrolling.

Please either

elect or waive

coverage.

Please either elect or

waive coverage.

Once you have completed your enrollment, you will be directed to a Confirmation Statement. This page will be a listing

of all the coverage you have for 2016 calendar year. Feel free to print out this form if you would like.