Step 3

Benefit Selection

Complete your optional benefits selection.

Hitachi Vantara has organized the following optional benefits that are only available to employees and their eligible dependents. All optional benefits are employee paid through payroll deduction.

Choose from the following benefits.

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Employee / Member Information

Please complete the following required information.
Password
First Name
Last Name
Date of Birth
Sex Male Female
Smoker Yes No
Employee Email

Optional Benefits

(Click on the + to expand/contract the section where available.)

This benefit must be selected at the time you enroll in the group plan and cannot be changed at a later date. Should you decline coverage, Option 1 and 2 will only be available within 31 days of adding your first dependent.

Option 1 Option 2 I Decline
Spouse
Child
Premium

Select Your Coverage

Date of Birth
Age
Sex Male Female
Smoker Yes No
Select Your Coverage

Age
Select Your Coverage

Date of Birth
Age
Sex MaleFemale
Smoker Yes No
Select Your Coverage

Select Your Coverage Yes
No
Benefit
Total Monthly Premium




Proceed to Step 4
Back to Step 2