Small Business Broker Reference Guide. Illinois & Northwest Indiana

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Small Business Broker Reference Guide. Illinois & Northwest Indiana"

Transcription

1 Small Business Broker Reference Guide Illinois & Northwest Indiana segment January 1, 2014

2 We are proud of our commitment to agents throughout Illinois and Northwest Indiana. We recognize the value you bring to small business, and your critical role in the partnership between small employers and UnitedHealthcare. Our staff is dedicated to servicing your needs and those of the employer. The information in this guide is intended as a tool designed to help you better understand: Medical underwriting requirements Pre-sale Guidelines Post-sale administrative options and eligibility provisions Specialty Benefits Guidelines. 2

3 Medical underwriting requirements Medical Underwriting requirements may change and Medical Underwriting reserves the right to request additional information as they deem necessary. In addition, if there are discrepancies between this document and any employer contract or certificate of coverage, the contract or certificate of coverage will prevail. Document Updated: November 2013 Category Medical history requirement (Applications and requirements may vary by state.) Rating structure Submit to: or send to your local General Agent representative. Dual, Triple, and Flexible Options Excluding classes (Not permitted in Indiana) Requirements for competitor application prescreen IL and NW IN or send to your local General Agent representative. Required for fast track submission Requirements for Medical Underwriting Explanation/Requirements Employees at groups with eligible employees will be required to complete. Illinois Enrollment Application Form # (located on UnitedeServices.com under Forms IL Employee) Indiana Enrollment Application Form # (located on UnitedeServices.com under Forms IN Employee) Rating structure is based on the Average Total Number of Employees (ATNE). Employees will be composite rated. Available for groups with 51 or more enrolling employees. For groups with 51 to 99 eligible employees, there should not be more than a 50% spread between the highest and lowest rated plan. Groups may select up to 5 benefit plan options.. On groups with 51 to 99 eligible employees, up to two classes will be permitted. Examples of acceptable classes include: hourly and salaried, union and non-union, management and non-management. Completed and signed Competitor Applications (height and weight required for all enrolling members) Employer Authorization form (located on UnitedeServices.com under Forms IL Employer) Completed Fast Track Coversheet (located on UnitedeServices.com under Forms IL Broker) Completed and signed enrollment forms including COBRA and Waivers for all eligible employees (height and weight required for all enrolling members) Completed Fast Track Coversheet (located on UnitedeServices.com under Forms IL Broker) Name of current carrier and group tax ID number For all new business with groups with 51 to 99 eligible employees. A renewal from the current carrier is required to receive individual medically underwritten rates. 3

4 Post Medical Underwriting / Case Installation Category Requirements for new business submission Submit to: Fax: Mail: UnitedHealthcare Small Group New Case Submission Suite E. Randolph St. Chicago, IL Or submit to your General Agent office. Billing statement requirements Enrollment form requirements Explanation/Requirements Enroll with direct deposit or submit a binder check for one months, premium payable to UnitedHealthcare of Illinois, Inc. (direct debit form located on UnitedeServices. com under Forms - IL - Employer) Completed Illinois Employer Application for Small Business Form # (located on UnitedeServices.com under Forms - IL - Employer) Completed Indiana Employer Application for Small Business Form # ) (located on UnitedeServices.com under Forms - IN - Employer) Completed and signed enrollment forms including COBRA and Waivers for all eligible employees (height and weight required for all enrolling members) Name of current carrier and group tax ID number Most recent statement (all pages) All terminated employees clearly marked, including termination date(s) Cobra/Continuation applications or waivers included if terminated within days and still listed on billing statement All medical history questions answered and explained All information fully completed and signed by subscriber and spouse (if spouse is electing coverage) All applications must be signed and dated within 90 days of requested effective date Date of hire filled in on all applications Number of hours worked filled in all applications Other coverage information (Section D) must be filled in on all applications Members electing Navigate HMO must select a PCP - live or work rule applies 4

5 Category Employer contribution requirements Participation requirements Employees in waiting period Effective dates/backdating Independent contractor (1099) guidelines Common Ownership Seasonal employees PEO ( Professional Employee Organization ) groups Retiree coverage Employers utilizing leased employees Waiting periods Navigate (IL only) Explanation/Requirements Minimum of 50% of the average cost of the lowest plan. For all cases renewing, 70% of total eligible employees must be enrolled in coverage AFTER valid waivers are removed from consideration and there is no minimum requirement. Illinois ONLY: 25% floor of total eligible employees with no waivers. NW Indiana ONLY: 75% of total eligible employees must enroll in coverage, with no less than 50% of the total population. New clients will have the following compliant member waiting period options: No waiting period Date of event: 1 to 90 calendar days, 1 or 2 months First of month: following the event (such as date of hire), 1 or 2 month(s), or 1 to 60 calendar days 1st of the month effective date: A group must be medically underwritten no later than the 10th of the month in order to backdate coverage to the 1st of the month 15th of the month effective date: A group must be medically underwritten no later than the 25th of the month in order to backdate coverage to the 15th of the month Employers may select to offer coverage to their independent contractor (1099 employees), if the following conditions are met: The maximum number of 1099 contractors may not exceed 35% of the total number of enrolled subscribers. The Independent Contractor paid by 1099 must work for your company on a full time, year-round basis The 1099 contractor must work a minimum of 30 hours per week The employer agrees to contribute the same amount of money toward the premium as regular taxed employees The employer agrees to require the same waiting period for Independent Contractors as regular taxed employees The employer agrees to extend the coverage offering to all Independent Contractors who meet these qualifications, including any future 1099 employees The business has a minimum of two regular, taxed, employees who are applying (1099 form located on UnitedeServices.com under Forms - IL - Employer) (located on UnitedeServices.com under Forms - IL - Employer) Coverage for Seasonal Employees as defined as employees working a minimum of 30 hours per week less than 9 months per year is not offered. Coverage to PEOs and their employees is not offered pre 65 retiree coverage is available, no more than 20%. Post 65 coverage not available. All leased employees must be eligible for coverage on the same basis as other employees The employer must complete and sign the application for coverage UnitedHealthcare will bill the employer for coverage, not the PEO UnitedHealthcare must be the sole provider of health insurance for all eligible employees The required eligibility information will include the standard documents for any small employer group Waiting period before coverage is in place cannot exceed 90 days Primary Care Physician(PCP) selection will be required for installation. If a PCP is not selected, a PCP will be assigned by default. Submissions required 10 business days prior to the effective date. 5

6 Forms required for case installation Requirements Medical Life 1 Dental 1 Vision 1 Employer: ER application Prior billing statement Common Ownership Copy of binder check/direct debit form UnitedHealthcare Employer application Form # (located on UnitedeServices.com under Forms - IL - Employer) UnitedHealthcare Employer application Form # (located on UnitedeServices.com under Forms - IN - Employer) Medical pri or billing statement not required Dental prior & current billing statement not required Requirement for all products. (Commonwership Form located on UnitedeServices.com under Forms - IL - Employer) Medical premium Life premium Dental premium No binder check for voluntary dental and vision only Vision premium, Voluntary 2 not required Premium payment can be combined when multiple products are sold 1099 Requirement for all products. (1099 Form located on UnitedeServices.com under Forms - IL - Employer) Verification approval Verification approval from Broker with approved rates Employee: UnitedHealthcare Medical and Life Enrollment Form including PCP selection for IL Navigate HMO EE application business. (State specific) EE waiver Waivers not required for groups with 51 to 99 eligible employees. 1 For Life, Dental and Vision products, if there is an existing Medical product on another UnitedHealthcare platform we will not require the binder check or Wage & Tax docs and we can accept an enrollment spreadsheet in place of the employee enrollment forms (with the exception of Life over guaranteed issue which will require enrollment forms for underwriting review). 2 Voluntary definition Employer contributes less than 50% 3 For 100% Employer Paid Plans 6

7 Standard administrative guidelines/post-sale Category Effective date Payment grace period Delinquent policy Mandatory enrollment into products Date of birth calculation (age-banded rate changes) Maximum number of children billed (age/sex-rated groups) Open enrollment period Explanation/Requirements 1st or 15th of the month. All products regardless of effective date will share the same renewal date. Premium payment is due the 1st of each month. A 31-day grace period is allowed all premiums must be received and booked before the end of the grace period to avoid a policy termination. A policy that is not paid by the due date (including the grace period) is considered delinquent and may result in termination. If the employer contributes 100% toward any specialty benefits (life and AD&D, dependent life, or dental) premium, then the employees must elect that product s coverage. Northwest Indiana - All employees enrolled in Medical benefits must enroll in Life as well. 1st of the insurance month following date of age change 3 Month prior to renewal. Medical cards Mailed to employees home within 7 to 10 business days of the policy being issued. Employees can also log into myuhc.com within 72 hours of the policy being issued to print temporary ID cards Certificate of coverage Available online at myuhc.com within 72 hours of the policy being issued. Covered dependents Navigate (IL only) Employee s spouse Civil Union (IL Only) Handicap/Disabled dependent Any unmarried dependent child under 26 years of age or Any unmarried dependent child under 30 years of age if the dependent (i) is an Illinois resident, (ii) served as an active or reserve member of any U.S. Armed Forces and (iii) received release or discharge other than dishonorable discharge. To be eligible the dependent must meet all three (3) of the conditions above and must submit to the insurer a form approved by the Illinois Department of Veterans Affairs stating the date on which the dependent was released from service. Adopted children Dependents such as nieces and nephews that are court ordered to be covered by member s group plan Grandchildren that are claimed as dependent(s) for federal tax purposes Members can change primary care physicians monthly Contact Customer Service or log on to myuhc.com to change primary care physicians New member health plan ID cards will be issued whenever a member changes their primary physician Changes submitted by the 15th of the month are effective the 1st of the next month (e.g. change submitted on June 15th effective July 1st) Changes submitted on/after the 16th of the month will be effective the 1st of the month after the next month (e.g. change submitted on June 16th effective August 1st) Retroactive changes are not permitted 7

8 Standard administrative guidelines/post-sale Deductible and out of pocket credit Effective date for new hires Minimum hours worked per week to be eligible Effective date of termination Effective date for return to employment (leave, strike, layoff ) Date for status change Qualifying events Dual coverage (employee works for 2 employers and is covered under both policies) Double coverage (husband/wife work for same employer and cover each other) Handicapped coverage Employer plan termination UnitedHealthcare groups are eligible at the group level for individual mid-year deductible and out of pocket credit from previous carrier. To obtain credit, the employee must have been enrolled on the plan prior to the transition. 1st of the policy month (1st, 15th, 28th) with 31-day notice hours per week if the groups elect medical-only coverage. (determined by employer group) hours per week if the groups elect ancillary coverage. (determined by employer group) Last day of the policy month (1st, 15th, 28th) in which the term occurs with 31-day notice. 1st of the policy month (1st, 15th, 28th) following date of return. 1st of the insurance month following change Newborns, new marriages and late adds with a qualifying event that we are notified of within 30 days are added on the date of the event Newborn, marriage, divorce, adoption, hardship, death and loss of other coverage Not allowed Not allowed Coverage can exceed standard dependent age requirements. Statement of Dependent Eligibility Beyond Limiting Age Due to Mental or Physical Disability (form # M46637) must be completed by the dependents physician. (Form located on UnitedeServices.com under Forms - IL - Employee) UnitedHealthcare may terminate group coverage for: Nonpayment of premiums (The group is liable for payment of premiums for the entire term the policy is in force, including the grace period.) Not meeting contribution requirements (31 days advance notice) Not meeting participation requirements (31 days advance notice) Voluntary termination Coverage may be terminated on the date specified by the policyholder, with at least 31 days prior written notice to UnitedHealthcare. The written notice must be on company letterhead signed by an officer of the group/policyholder. Application for group coverage within 6 months of termination date will result in the same or greater premium cost as was in effect at time of termination. Exclusions and coverage limitations are detailed in the group contract and the member certificate of coverage. If this document conflicts in any way with the group contract or the certificate of coverage, the contract/certificates provisions prevail. 8

9 Groups previously terminated for non-payment Specialty Guidelines Dental Guidelines Contribution Participation Waiting period for major services Dental Dual Option Voluntary Employer contributes less than 50% of single premium. Employer Paid Employer contributes 50% or more of single premium. Employer Paid 75% of eligible employees, net of waivers Voluntary 2 enrolled minimum 8 enrolled minimum with ortho 10+ eligible Minimum of 51%, including waivers Note: It is not required that the same employees that choose medical coverage also choose dental coverage. The waiting period is waived if group had prior dental coverage. Please Note: Proof of 12 months prior coverage (including major services or ortho, if applicable) is required in order to waive the waiting period. Available with any dental plan for groups with a minimum of 10 dental enrollees. Ortho available for groups with a minimum of 10 eligible employees with a minimum of 8 enrolled. Critical Illness Protection Plan (51-99 only) Participation Employer Paid base with employee buy-up 100% of 20% Voluntary (100% Employee paid) 20% participation Non-Contributory (100% Employer paid) 100% participation Benefit Amount Non-Contributory Option 1 $5,000 Employee only Option 2 $10,000 Employee only Voluntary Option 1 $5,000 Employee only Option 2 $10,000 Employee, $5,000 Spouse, $2,500 child(ren) Employer Paid base with employee buy-up Option 1 $5,000 Employee paid base, $10,000 Employee, $5,000 Spouse, $2,500 child(ren) Option 2 $10,000 Employee paid base, $10,000 Employee, $5,000 Spouse, $2,500 child(ren) 9

10 Lives Employee/Dependent Basic Life & ADD Installation Platform Case Requirements Availability Portal Access Employee Participation Requirements Employer Contributions Rating Methodology Eligibility Requirements Eligibility Waiting Period PRIME Basic Employee Life & AD&D Selected types of businesses are ineligible (see SIC code list) Must be sold with Employee Life Basic Dependent Life Employee must elect Employee Life to elect Basic Dep Life Employee access to COC on myuhc.com available only if sold with Medical Employer access to eservices is available Non-Contributory - 100% Not Applicable Contributory - minimum of 75% participation Non-Contributory - 100% employer paid 0% employer paid Contributory - 25% employer paid Composite Rates Flat Rate per employee 24 Month Rate Guarantee the 1st of the month after date of hire the date of hire Waiting Period: X or 1st of month after X, Not Applicable where X = months may be expressed in months Min. # Hours Full-time = 20 hour/week Not Applicable Open Enrollment Not available to Small Business Not Applicable Domestic Partners Not Applicable Available Lives LTD Installation Platform PRIME Case Requirements Availability May be sold as stand-alone (51-99) Portal Access Employer access to eservices available only if sold with Medical, Dental, Vision or Basic Life Employee access to COC on myuhc.com available only if sold with Medical Employer Eligibility Groups must be in business for a minimum of 2 years Groups must not contain more than 50% immediate family members Selected types of businesses ineligible (see SIC code list) Employee Participation Requirements Non-Contributory-100% (2-99) Contributory-50% (10-99) Voluntary-25% (10-99) Employer Contributions Non-Contributory - 100% employer paid (2-99) Contributory - Employer & Employee share (10-99) Voluntary- 0% employer paid (10-99) Rating Methodology Contributory/Non-Contributory - Composite per $100 of Monthly Covered Payroll (MCP) Voluntary - Age banded per $100 of MCP 24 Month Rate Guarantee Eligibility Requirements Eligibility Waiting Period: X or 1st of month after X, where X = months Waiting Period may be expressed in months Min. # Hours Full-time = 30 hour/week 10

11 Lives STD Installation Platform PRIME Case Requirements Availability Can be sold stand alone Portal Access Employer access to eservices available only if sold with Medical, Dental, Vision or Basic Life Employee access to COC on myuhc.com available only if sold with Medical Employer Eligibility Groups must be in business for a minimum of 2 years (1 year if preferred industry) Groups must not contain more than 50% immediate family members Employees working in CA, HI, RI, NY, NJ and Puerto Rico are not eligible for STD coverage. Selected types of businesses ineligible (see SIC code list) Employee Participation Requirements EE participation: Non-Contributory - 100% participation Contributory - minimum of 50% participation Voluntary - minimum of 25% participation ER Contribution: Non-Contributory - 100% employer paid Contributory - minimum 25% employer paid Voluntary - 0% employer paid Employer Contributions 100% employer paid Rating Methodology Composite per $10 of Weekly Benefit; Age banded rates available. 24 Month Rate Guarantee Eligibility Requirements Eligibility Waiting Period Min. # Hours Waiting Period: X or 1st of month after X, where X = 30 days 60 days 90 days may be expressed in months Full-time = 30 hour/week The Definity SM Health Savings Account (HSA) high deductible health plan (HDHP) is designed to comply with IRS requirements so eligible enrollees may open a Health Savings Account with a bank of their choice or through OptumHealth Bank, Member of FDIC. Definity HSA refers generally to the Definity SM HSA product, which includes a HDHP, although at times Definity HSA may refer only and specifically to the Definity Health Savings Account, provided in conjunction with OptumHealth Bank and not to the associated HDHP. UnitedHealthcare s Definity SM Health Reimbursement Account, or HRA, combines the flexibility of a medical benefit plan with an employer-funded reimbursement account. UnitedHealthcare Vision coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by Spectera, Inc., United HealthCare Services, Inc. or their affiliates. UnitedHealthcare Dental coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by Dental Benefit Providers, Inc., Dental Benefit Administrative Services (CA only), United HealthCare Services, Inc. or their affiliates. UnitedHealthcare Life and Disability products are provided by UnitedHealthcare Insurance Company, Unimerica Insurance Company or Unimerica Life Insurance Company of New York. UnitedHealth Wellness is a collection of programs and services offered to UnitedHealthcare enrollees to help them stay healthy. It is not an insurance product but is offered to existing enrollees of certain products underwritten or provided by UnitedHealthcare Insurance Company or its affiliates to encourage their participation in wellness programs. Health care professional availability for certain services may be dependent on licensure, scope of practice restrictions or other requirements in the state. Some UnitedHealth Wellness programs and services may not be available in all states or for all group sizes. Components subject to change. For a complete description of the UnitedHealth Premium Designation program, including details on the methodology used, geographic availability, program limitations and medical specialties participating, please see myuhc.com. The Healthy Pregnancy Program follows national practice standards from the Institute for Clinical Systems Improvement. The Healthy Pregnancy Program can not diagnose problems or recommend specific treatment. The information provided is not a substitute for your doctor s care. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by UnitedHealthcare Insurance Company, United HealthCare Services, Inc. or their affiliates. Insurance coverage provided by or through UnitedHealthcare Insurance Company and UnitedHealthcare Insurance Company of Illinois or their affiliates. Health Plan coverage provided by or through UnitedHealthcare of Illinois, Inc. M41786-B 1/ UnitedHealthcare Services, Inc. 11

Small Business Broker Reference Guide. Illinois & Northwest Indiana

Small Business Broker Reference Guide. Illinois & Northwest Indiana Small Business Broker Reference Guide Illinois & Northwest Indiana 2-50 segment January 1, 2014 We are proud of our commitment to agents throughout Illinois and Northwest Indiana. We recognize the value

More information

MEDICAL UNDERWRITING GUIDELINES LARGE GROUP

MEDICAL UNDERWRITING GUIDELINES LARGE GROUP MEDICAL UNDERWRITING GUIDELINES LARGE GROUP This comparison reflects the general guidelines set by a carrier. Guidelines may vary depending on group demographics and carrier approval. Product Networks

More information

Plan Guide Mississippi. Plans Effective July 1, 2010 For businesses with up to 50 employees

Plan Guide Mississippi. Plans Effective July 1, 2010 For businesses with up to 50 employees Plan Guide Mississippi Plans Effective July 1, 2010 For businesses with up to 50 employees Why choose UnitedHealthcare? Better information alerts individuals and their doctors of health risks or opportunities

More information

All Savers. All Savers Alternate Funding For the health of your business. Employer Guide

All Savers. All Savers Alternate Funding For the health of your business. Employer Guide All Savers All Savers Alternate Funding For the health of your business Employer Guide Table of Contents Important Contact Information General Correspondence P.O. Box 19032 Green Bay, WI 54307-9032 Fax:

More information

Aetna Funding Advantage (AFA) Underwriting Brochure

Aetna Funding Advantage (AFA) Underwriting Brochure Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Funding Advantage (AFA) Underwriting Brochure Plans effective January 1, 2016 For businesses with 10 enrolled

More information

Oxford New York Small Group (1-100) Underwriting Requirements

Oxford New York Small Group (1-100) Underwriting Requirements Oxford New York Small Group (1-100) Underwriting Requirements ALL GROUPS OXFORD HEALTH INSURANCE, INC. (OHI) & OXFORD HEALTH PLANS (NY), INC. (OHP) The following underwriting requirements apply to all

More information

State of Florida Qualifying Status Change Event Matrix

State of Florida Qualifying Status Change Event Matrix A. Change in Enrollee s Legal Marital Status Marriage 1. Legally recognized marriage between two persons under any state or foreign law at the time the marriage was entered into by the parties. Common

More information

New York underwriting brochure

New York underwriting brochure Quality health plans & benefits Healthier living Financial well-being Intelligent solutions New York underwriting brochure Plans effective January 1, 2016 For businesses with 1 100 full-time equivalents

More information

Get to know your benefits. State of Florida 2018 Benefits Guide. welcometouhc.com/florida

Get to know your benefits. State of Florida 2018 Benefits Guide. welcometouhc.com/florida Get to know your benefits. State of Florida 2018 Benefits Guide welcometouhc.com/florida Knowing your benefits helps you make more informed choices. By understanding your benefits, you can select the coverage

More information

Group Administration Manual. For all group sizes Missouri and Wisconsin MUEENABS Rev. 9/12

Group Administration Manual. For all group sizes Missouri and Wisconsin MUEENABS Rev. 9/12 Group Administration Manual For all group sizes Missouri and Wisconsin 23631MUEENABS Rev. 9/12 Member services information for your convenience Health coverage inquiries Anthem Blue Cross and Blue Shield

More information

Salaried Medical, RX, Dental and Vision SPD

Salaried Medical, RX, Dental and Vision SPD Medical, Dental and Vision Benefit Provisions of the CITGO Petroleum Corporation Medical, Dental, Vision and Life Insurance Program For Salaried Employees Summary Plan Description As in effect January

More information

UnitedHealthcare OPTIMUM CHOICE HMO PLAN with a HEALTH SAVINGS ACCOUNT

UnitedHealthcare OPTIMUM CHOICE HMO PLAN with a HEALTH SAVINGS ACCOUNT Medical UnitedHealthcare OPTIMUM CHOICE HMO PLAN PLAN FEATURES } A referral-based plan where you work closely with your primary care physician for appropriate, cost-effective care } A strong local network

More information

Plan Guide Louisiana. Plans Effective July 1, 2010 For businesses with up to 50 employees

Plan Guide Louisiana. Plans Effective July 1, 2010 For businesses with up to 50 employees Plan Guide Louisiana Plans Effective July 1, 2010 For businesses with up to 50 employees Why choose UnitedHealthcare? Better information alerts individuals and their doctors of health risks or opportunities

More information

Large Business Application

Large Business Application Large Business Application for Group Service Agreement/Group Policy Medical and Life/AD&D plans are provided by Health Net of California, Inc. and/or Health Net Life Insurance Company (together, Health

More information

Small Business Guidelines

Small Business Guidelines The following policy and qualification guidelines apply to all employers offering Kaiser Permanente small business coverage. ELIGIBILITY You may be eligible for Kaiser Permanente s guaranteed issue and

More information

Illinois Standard Health Employee Application for Small Employers

Illinois Standard Health Employee Application for Small Employers Illinois Standard Health Employee Application for Small Employers INSURER USE ONLY Policy/Group No. Section No. Effective Date New Hire Waiting Period For assistance in completing this application, please

More information

Here s all the nitty gritty.

Here s all the nitty gritty. Here s all the nitty gritty. Oscar for Business Underwriting Guidelines Small group health plans for New York es with 1-100 full-time equivalent employees Effective on or after April 1, 2017 Welcome to

More information

2016 Virginia Small Group (1-50) Health Plan Portfolio

2016 Virginia Small Group (1-50) Health Plan Portfolio 2016 Virginia Small Group (1-50) Health Plan Portfolio What do you value in a health plan? You want to offer benefits that attract employees and keep them healthy. UnitedHealthcare provides a variety of

More information

Healthcare Participation Section MMC Draft NA

Healthcare Participation Section MMC Draft NA March 17, 2009 Healthcare Participation Section MMC Draft NA Note to Reviewers: No notes at this time Date May 1, 2009 Participating in Healthcare Benefits MMC Participating in Healthcare Benefits This

More information

California Small Group Business Employer Application

California Small Group Business Employer Application California Small Group Business Employer Application FOR GROUP COVERAGE (1-100 EMPLOYEES) PENDING REGULATORY APPROVAL TO COMPLY WITH CALIFORNIA LAW, WHEREVER THE TERM "SPOUSE" APPEARS IT SHALL BE CONSTRUED

More information

General Information Book for active employees of the State of New York, their enrolled dependents, COBRA enrollees and Young Adult Option enrollees

General Information Book for active employees of the State of New York, their enrolled dependents, COBRA enrollees and Young Adult Option enrollees 2017 NY Active Employees New York State Health Insurance Program for active employees of the State of New York, their enrolled dependents, COBRA enrollees and Young Adult Option enrollees New York State

More information

Anthem Health Plans of Kentucky, Inc.

Anthem Health Plans of Kentucky, Inc. Employee Enrollment Application For 2 50 Employee Small s Kentucky Anthem Plans of Kentucky, Inc. Anthem Life Insurance Company You, the employee, must complete this application. You are solely responsible

More information

PPI Benefit Solutions RESEARCH. Fourth Annual Nonprofit Employee Benefits Study Supplemental Report

PPI Benefit Solutions RESEARCH. Fourth Annual Nonprofit Employee Benefits Study Supplemental Report PPI Benefit Solutions RESEARCH Fourth Annual Nonprofit Employee Benefits Study Supplemental Report ABOUT THE STUDY The PPI Benefit Solutions (PPI) Fourth Annual Nonprofit Employee Benefits Study measures

More information

DIXON PUBLIC SCHOOLS DISTRICT #170 All Other Staff (hired prior to July 1, 2013) Health Care Plan

DIXON PUBLIC SCHOOLS DISTRICT #170 All Other Staff (hired prior to July 1, 2013) Health Care Plan DIXON PUBLIC SCHOOLS DISTRICT #170 All Other Staff (hired prior to July 1, 2013) Health Care Plan Benefit Booklet/Plan Document Effective September 1, 2006 Restated March 1, 2015 Table of Contents Page

More information

Group Application (Delta Dental, VSP and Unum Life & LTD)

Group Application (Delta Dental, VSP and Unum Life & LTD) Group Application (Delta Dental, VSP and Unum Life & LTD) Group Information Company Name: DBA: Street Address: City: State: Zip: Billing Address (if different): City: State: Zip: Employer is: Partnership

More information

WELCOME TO THE 2017 SUMMARY PLAN DESCRIPTION FOR ACTIVE EMPLOYEES

WELCOME TO THE 2017 SUMMARY PLAN DESCRIPTION FOR ACTIVE EMPLOYEES SUMMARY PLAN DESCRIPTION FOR HEALTH AND WELFARE BENEFITS OF ACTIVE EMPLOYEES EFFECTIVE JANUARY 1, 2017 Table of contents WELCOME TO THE 2017 SUMMARY PLAN DESCRIPTION FOR ACTIVE EMPLOYEES MUFG Union Bank,

More information

Employer Application (Delta Dental, VSP, and Unum Life & LTD)

Employer Application (Delta Dental, VSP, and Unum Life & LTD) Employer Application (Delta Dental, VSP, and Unum Life & LTD) Group Information Company Name: DBA: Street Address: City: State: Zip: Billing Address (if different): City: State: Zip: Contact Name: E-mail:

More information

2017 Rhode Island Small Group (1-50) Health Plan Portfolio.

2017 Rhode Island Small Group (1-50) Health Plan Portfolio. 2017 Rhode Island Small Group (1-50) Health Plan Portfolio. What do you value in a health plan? Businesses today are faced with a lot of difficult decisions. Finding the right health care benefits plan

More information

2018 Rhode Island Small Group (1 50) Health Plan Portfolio.

2018 Rhode Island Small Group (1 50) Health Plan Portfolio. 2018 Rhode Island Small Group (1 50) Health Plan Portfolio. What do you value in a health plan? Businesses today are faced with a lot of difficult decisions. Finding the right health care benefits plan

More information

The New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan

The New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan The New Jersey Individual Health Coverage Program Buyer s Guide How to Select a Health Plan Published by: New Jersey Individual Health Coverage Program Board P.O. Box 325 Trenton, NJ 08625-0325 Web Address:

More information

Your Health Care Benefit Program

Your Health Care Benefit Program Your Health Care Benefit Program BLUE ADVANTAGE HMO A Blue Cross HMO a product of Blue Cross and Blue Shield of Illinois HMO GROUP CERTIFICATE RIDER This Certificate, to which this Rider is attached to

More information

2017 Benefits Summary Plan Description. For Campus Retirees

2017 Benefits Summary Plan Description. For Campus Retirees 2017 Benefits Summary Plan Description For Campus Retirees ii 2017 BENEFITS SUMMARY PLAN DESCRIPTION FOR CAMPUS RETIREES TABLE OF CONTENTS CALTECH RETIREE HEALTH AND LIFE BENEFITS PROGRAM... 1 ABOUT THIS

More information

My Rewards Benefits Enrollment Guide. Newly Eligible U.S. Team Members. My Pay/Recognition My Benefits My Work/Life My Career Growth

My Rewards Benefits Enrollment Guide. Newly Eligible U.S. Team Members. My Pay/Recognition My Benefits My Work/Life My Career Growth My Rewards Newly Eligible U.S. Team Members My Pay/Recognition My Benefits My Work/Life My Career Growth 2016 Benefits Enrollment Guide 2 2016 Benefits Enrollment Guide - Newly Eligible U.S. Team Members

More information

Reporting Requirements FAQs

Reporting Requirements FAQs Reporting Requirements - 6055 Frequently Asked Questions Reporting Requirements - 6055 FAQs Summary On March 10, 2014, the U.S. Department of the Treasury and IRS published final rules to implement the

More information

Compass Group 2016 Benefits-at-a-Glance For Ongoing Enrollment

Compass Group 2016 Benefits-at-a-Glance For Ongoing Enrollment Compass Group 206 Benefits-at-a-Glance For Ongoing Enrollment We understand that each of our associates have unique needs. That is why Compass Group offers a variety of benefit options, plus tools and

More information

AmeriShare Field Underwriting Guide

AmeriShare Field Underwriting Guide The purpose of this guide is to make your job easier and to help you get your client through ATA s acceptance process as quickly as possible. The more you know about how American Trust Administrators Underwriting

More information

Please fill out in blue or black ink only. Section A: Employee Information Last name First name M.I. Social Security no.

Please fill out in blue or black ink only. Section A: Employee Information Last name First name M.I. Social Security no. Employee Enrollment Form For 1-50 Employee Small s 1 New Hampshire You, the employee, must fill out this enrollment form. You must be sure that all the information is correct and that you fill out all

More information

Health Care Plans A14742W. Health Care Plans 2009 Edition

Health Care Plans A14742W. Health Care Plans 2009 Edition Health Care Plans Summary Plan Description 2009 Edition/Union-Represented Employees IBCJA 721; IBEW 2295; IBPATA 36; IBT 578 and 952; UAW 864, 887, 952, 1519, and 1558; SMWIA 461 The summary plan description

More information

Pennsylvania Dependent Coverage Eligibility FAQ

Pennsylvania Dependent Coverage Eligibility FAQ Pennsylvania Dependent Coverage Eligibility FAQ Effective December 7, 2009 for new or renewing fully insured small business and key accounts plans sitused in Pennsylvania, The State of Pennsylvania requires

More information

Caterpillar Inc. Retiree Benefit Program

Caterpillar Inc. Retiree Benefit Program Caterpillar Inc. Retiree Benefit Program Summary Plan Description Caterpillar Retirees Who Retired On or After February 1, 1991, Caterpillar Global Mining LLC Retirees, and Certain Solar Turbines Incorporated

More information

Summary Plan Description and Plan Document for the MEIJER HEALTH BENEFITS PLAN. (Restated as of the first day of the 2017 Plan Year)

Summary Plan Description and Plan Document for the MEIJER HEALTH BENEFITS PLAN. (Restated as of the first day of the 2017 Plan Year) Summary Plan Description and Plan Document for the MEIJER HEALTH BENEFITS PLAN (Restated as of the first day of the 2017 Plan Year) TABLE OF CONTENTS INTRODUCTION... 1 ELIGIBILITY AND PARTICIPATION...

More information

The New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan

The New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan The New Jersey Individual Health Coverage Program Buyer s Guide How to Select a Health Plan Published by: New Jersey Individual Health Coverage Program Board P.O. Box 325 Trenton, NJ 08625-0325 Web Address:

More information

We ve Got You Covered.

We ve Got You Covered. We ve Got You Covered. 2018 U.S. Health & Welfare Annual Enrollment November 6-17, 2017 UNDER ROOF The Newell Brands family is under one roof with a new benefits program for 2018. Here are the many valuable

More information

Commercial Underwriting Package

Commercial Underwriting Package Commercial Underwriting Package Commercial health insurance coverage is available to employer, trust and association groups, subscribers and dependents that meet the qualifications specified in 4235 (c)

More information

American Airlines, Inc. Health & Welfare Plan for Active Employees. Summary Plan Description. Effective January 1, 2018

American Airlines, Inc. Health & Welfare Plan for Active Employees. Summary Plan Description. Effective January 1, 2018 American Airlines, Inc. Health & Welfare Plan for Active Employees Summary Plan Description Effective January 1, 2018 Revised December 15, 2017 Table of Contents Eligibility and Enrollment... 2 Medical

More information

*Name (Last, First, MI) Please Print *Social Security Number *Date of Birth *Gender *Relation

*Name (Last, First, MI) Please Print *Social Security Number *Date of Birth *Gender *Relation SGI-12 11/15 Dependent Eligibility Certification Form If you cover dependents under any State Group Insurance plan, you must certify their eligibility by completing this form before any changes to your

More information

Benefits After Separation

Benefits After Separation Benefits After Separation A Guide in Transfer, Termination, & Retirement Full-time Academic & Staff Employees of Indiana University JAN 2017 Foreward Indiana University provides a variety of benefit plans

More information

UNDERWRITING GUIDELINES THE AFFILIATED PHYSICANS AND EMPLOYERS HEALTH PLAN MEWA

UNDERWRITING GUIDELINES THE AFFILIATED PHYSICANS AND EMPLOYERS HEALTH PLAN MEWA UNDERWRITING GUIDELINES THE AFFILIATED PHYSICANS AND EMPLOYERS HEALTH PLAN MEWA Plans effective July 1, 2016 This material is intended for agents and brokers. It is not intended to be all inclusive. Other

More information

Bank of America Retiree Health and Insurance Summary Plan Description 2011

Bank of America Retiree Health and Insurance Summary Plan Description 2011 Bank of America Retiree Health and Insurance Summary Plan Description 2011 Bank of America Retiree Health and Insurance Summary Plan Description 2011 About this Summary This Retiree Health and Insurance

More information

Handbook. TreeHouse Foods, Inc. Health and Welfare Benefits Plan. Non-union Employees. Effective January 1, 2017

Handbook. TreeHouse Foods, Inc. Health and Welfare Benefits Plan. Non-union Employees. Effective January 1, 2017 Handbook TreeHouse Foods, Inc. Health and Welfare Benefits Plan Non-union Employees Effective January 1, 2017 This document, together with each of the benefits booklets and insurance contracts of coverage,

More information

Open Enrollment What you need to know to choose your benefits plan

Open Enrollment What you need to know to choose your benefits plan Open Enrollment 2016 What you need to know to choose your benefits plan Today s Presentation Making Your Choice How Vitality Can Lower Your Costs Important Rules Flexible Spending and Dependent Care Accounts

More information

Summary Plan Description. Important Benefits Information. Please keep this SPD for future reference. DISTRIBUTION

Summary Plan Description. Important Benefits Information. Please keep this SPD for future reference. DISTRIBUTION Summary Plan Description Important Benefits Information Cingular Wireless Vision Program This summary plan description (SPD) is a guide for using the Cingular Wireless Vision Program (Program), a component

More information

New Business New Hire New Renewal New COBRA Qualifying/Triggering Event. Address. Spouse/Domestic Partner Child 1 Child 2 Child 3

New Business New Hire New Renewal New COBRA Qualifying/Triggering Event.  Address. Spouse/Domestic Partner Child 1 Child 2 Child 3 721 South Parker, Suite 200, Orange, CA 92868 (800) 558-8003 www.calchoice.com / / Life / Enrollment Application Select one A Personal Information Company Name COMPLETE WAIVER SECTION ON PAGE 4 IF YOU

More information

Policies of the University of North Texas. Chapter 05. Human Resources Optional Group Insurance Programs

Policies of the University of North Texas. Chapter 05. Human Resources Optional Group Insurance Programs Policies of the University of North Texas 05.034 Optional Group Insurance Programs Chapter 05 Human Resources Policy Statement. To provide eligible faculty, staff, and graduate students the opportunity

More information

Retiree Benefits Handbook. An overview of health benefits available to Sacramento County Annuitants

Retiree Benefits Handbook. An overview of health benefits available to Sacramento County Annuitants Retiree Benefits Handbook An overview of health benefits available to Sacramento County Annuitants 2016 I N T R O D U C T I O N The County of Sacramento is committed to your overall health and well-being,

More information

Retiree Dental Plan Dental PPO/PDN with PPO II Network. Summary Plan Description

Retiree Dental Plan Dental PPO/PDN with PPO II Network. Summary Plan Description Retiree Dental Plan Dental PPO/PDN with PPO II Network Summary Plan Description December 2014 Table of Contents Introduction... 1 Eligibility and Enrollment... 2 Eligibility... 2 Enrollment... 2 Contributions...

More information

2014 Benefits At-A-Glance

2014 Benefits At-A-Glance 2014 Benefits At-A-Glance This brochure explains some of the features of the Mount Sinai benefit plans. Complete details of each of the plans are contained in the official plan documents or insurance contracts.

More information

Administrative Guideline and Procedures

Administrative Guideline and Procedures Administrative Guideline and Procedures This guide is intended for small groups, those with less than 50 employees. Large groups may find these guidelines useful as well. Paramount s Administrative Guide

More information

PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION FOR NORTHWEST LABORERS EMPLOYERS HEALTH & SECURITY TRUST FUND REVISED EDITION APRIL 2010

PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION FOR NORTHWEST LABORERS EMPLOYERS HEALTH & SECURITY TRUST FUND REVISED EDITION APRIL 2010 PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION FOR NORTHWEST LABORERS EMPLOYERS HEALTH & SECURITY TRUST FUND REVISED EDITION APRIL 2010 1 NORTHWEST LABORERS-EMPLOYERS HEALTH & SECURITY TRUST FUND INTRODUCTION

More information

2018 HSA GUIDE. ...Your Benefits

2018 HSA GUIDE. ...Your Benefits ...Your Benefits 2018 HSA GUIDE The HSA Plan consists of two parts that work together to give you more control over how you receive and pay for medical care and services, both now and in the future: the

More information

Your Health Care Benefit Program

Your Health Care Benefit Program Your Health Care Benefit Program BLUE ADVANTAGE HMO A Blue Cross HMO a product of Blue Cross and Blue Shield of Illinois A message from BLUE CROSS AND BLUE SHIELD Your Group has entered into an agreement

More information

CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA)

CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) Office of Employee Benefits Administrative Manual CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) 250 INITIAL EFFECTIVE DATE: SEPTEMBER 1, 2005 LATEST REVISION DATE: AUGUST 1, 2013 PURPOSE: To provide

More information

Producer Performance Guide. Downstate New York

Producer Performance Guide. Downstate New York 2009 Producer Performance Guide Downstate New York Table of Contents 2 Resources Web Sites Terms Used In This Guide Area Covered By This Guide Case Size Designations Definitions 4 5 7 10 15 25 Medical

More information

2016 Massachusetts Small Group (1-50) Health Plan Portfolio

2016 Massachusetts Small Group (1-50) Health Plan Portfolio 2016 Massachusetts Small Group (1-50) Health Plan Portfolio What do you value in a health plan? Businesses today are faced with a lot of difficult decisions. Finding the right health care benefits plan

More information

American Airlines, Inc. Health & Welfare Plan for Active Employees. Summary Plan Description

American Airlines, Inc. Health & Welfare Plan for Active Employees. Summary Plan Description American Airlines, Inc. Health & Welfare Plan for Active Employees Summary Plan Description Effective January 1, 2017 Table of Contents Eligibility and Enrollment... 2 Medical Benefits... 37 Prescription

More information

How to Choose a Health Plan. A health insurance guide for federal employees.

How to Choose a Health Plan. A health insurance guide for federal employees. How to Choose a Health Plan A health insurance guide for federal employees. Types of plans Fee-for-Service (FFS) Preferred Provider Organization (PPO) A fee-for-service plan reimburses you or your provider

More information

My Rewards Benefits Enrollment Guide. U.S. Team Members. My Pay/Recognition My Benefits My Work/Life My Career Growth

My Rewards Benefits Enrollment Guide. U.S. Team Members. My Pay/Recognition My Benefits My Work/Life My Career Growth My Rewards U.S. Team Members My Pay/Recognition My Benefits My Work/Life My Career Growth 2018 Benefits Enrollment Guide 2 2018 Benefits Enrollment Guide - U.S. Contents Benefits Enrollment... Page 3 2018

More information

FSA with Flex Card. Enrollment Kit. What s inside: Getting to Know: FSA with Flex Card. Eligible Expenses. Flex Card Overview

FSA with Flex Card. Enrollment Kit. What s inside: Getting to Know: FSA with Flex Card. Eligible Expenses. Flex Card Overview FSA with Flex Card Enrollment Kit What s inside: Getting to Know: FSA with Flex Card Eligible Expenses Flex Card Overview Participant Web Site & Mobile App Overview Election Form Flexible Benefit Service

More information

All Savers Dental, Vision and Life Insurance Plans

All Savers Dental, Vision and Life Insurance Plans All Savers Dental, Vision and Life Insurance Plans Employer product overview Dental insurance Dental Preferred Provider Organization (PPO) Plan Unlimited choices. Significant savings. Yours with the PPO

More information

CHAPTER 27 COBRA CONTINUATION OF COVERAGE

CHAPTER 27 COBRA CONTINUATION OF COVERAGE CHAPTER 27 COBRA CONTINUATION OF COVERAGE Introduction The continuation of coverage provision of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees

More information

Underwriting guidelines for brokers and producers

Underwriting guidelines for brokers and producers KAISER PERMANENTE FOR SMALL BUSINESS CALIFORNIA Underwriting guidelines for brokers and producers Kaiser Foundation Health Plan, Inc. Kaiser Permanente Insurance Company For businesses with 1 to 100 employees

More information

The New Jersey. The Small Employer Health Benefits Program BUYER S GUIDE

The New Jersey. The Small Employer Health Benefits Program BUYER S GUIDE The New Jersey Small Employer Health Benefits Program BUYER S GUIDE Published by: The Small Employer Health Benefits Program P.O. Box 325 Trenton, NJ 08625 0325 Visit Us on the Web At: www.dobi.nj.gov/seh/

More information

COBRA Common Questions: Administration

COBRA Common Questions: Administration Brought to you by Memorial Financial Services Corporation COBRA Common Questions: Administration The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that covered employers provide

More information

BENEFITS ENROLLMENT GUIDE FOR NEW HIRES

BENEFITS ENROLLMENT GUIDE FOR NEW HIRES BENEFITS ENROLLMENT GUIDE FOR NEW HIRES 2014 These instructions will help you navigate through the enrollment process in making your benefit elections as a new employee. RESOURCES If you have additional

More information

Group Administration Manual. For All Group Sizes Kentucky, Indiana and Ohio. EMMWBRO-206 Rev. 3/11

Group Administration Manual. For All Group Sizes Kentucky, Indiana and Ohio. EMMWBRO-206 Rev. 3/11 Group Administration Manual For All Group Sizes Kentucky, Indiana and Ohio EMMWBRO-206 Rev. 3/11 Member Services Information For Your Convenience Health Coverage Inquiries Anthem Blue Cross and Blue Shield

More information

San Diego Community College District Enrollment Guide Benefits Enrollment Guide. Making Informed Decisions

San Diego Community College District Enrollment Guide Benefits Enrollment Guide. Making Informed Decisions San Diego Community College District 2018 Enrollment Guide 2018 Benefits Enrollment Guide Making Informed Decisions OPEN ENROLLMENT IS HERE During annual benefits enrollment, which runs from November 1

More information

Choice 100+ Frequently Asked Questions Brokers and Producers

Choice 100+ Frequently Asked Questions Brokers and Producers Choice 100+ Frequently Asked Questions Brokers and Producers 1 Choice 100+ Frequently Asked Questions Q: Who do members call for assistance for medical, pharmacy, dental, or vision? A: For questions about

More information

Please print clearly and fill in each applicable circle. Proposed effective date: / / Enrollment Information

Please print clearly and fill in each applicable circle. Proposed effective date: / / Enrollment Information Group Employee and Individual Application and Enrollment Form - 1-100 Employees Visit us at Humana.com Arizona The offering company(ies) listed below, severally or collectively, as the content may require,

More information

hospital indemnity insurance

hospital indemnity insurance hospital indemnity insurance Effective January 1, 2017, Chevron will offer a new Group Hospital Indemnity* Insurance underwritten by Continental American Insurance Company (CAIC), a wholly-owned subsidiary

More information

LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS

LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS Updated as of April 1, 2017 TABLE OF CONTENTS 1. INTRODUCTION... 1 2. ACTIVE MEMBER ELIGIBILITY...

More information

Delta Dental of California Manual

Delta Dental of California Manual Delta Dental of California Manual Table of Contents Welcome Letter 1 Contact Information 2 Quick Guide 3 Enrollment Guidelines 3 Choosing or Changing a Dentist 3 Eligibility 4 New Hires 4 Late Enrollees

More information

HealthSelectSM of Texas Plan

HealthSelectSM of Texas Plan HealthSelectSM of Texas Plan HealthSelect SM of Texas is self-funded, which means you and your dependents' health care claims are paid with funds provided by the State of Texas and through any contributions

More information

Garnett-Powers & Associates, Inc. University of Southern California Postdoctoral Scholar Benefit Program

Garnett-Powers & Associates, Inc. University of Southern California Postdoctoral Scholar Benefit Program Garnett-Powers & Associates, Inc. University of Southern California Postdoctoral Scholar Benefit Program Frequently Asked Questions (FAQ) Garnett-Powers & Associates, Inc. California Insurance License:

More information

RETIREE ORIENTATION EMPLOYEE BENEFITS OFFICE

RETIREE ORIENTATION EMPLOYEE BENEFITS OFFICE RETIREE ORIENTATION EMPLOYEE BENEFITS OFFICE THE TRANSITION Active MEDICAL DENTAL LIFE EAP FSA/HSA RHSP (ER contribution) Retiree MEDICAL DENTAL RHSP (Benefit eligible) HSA? Affordabl e Care Act?? THESE

More information

Administrative Handbook

Administrative Handbook Administrative Handbook Employee Benefits from Aetna California Your benefits administration tool kit 14.05.100.1-CA (9/11) Dear Plan Sponsor: Welcome! We re pleased you ve chosen Aetna and look forward

More information

Health Care Coverage You Need. A Company You Know.

Health Care Coverage You Need. A Company You Know. Health Care Coverage You Need. A Company You Know. 2018 Call 800-477-2000, visit bcbsil.com or contact an independent, authorized agent to get a quote today. When It s Time to Get Health Care Coverage,

More information

FERRIS STATE UNIVERSITY HEALTH PLAN SUPPLEMENTAL INFORMATION. Bargaining Unit Employees

FERRIS STATE UNIVERSITY HEALTH PLAN SUPPLEMENTAL INFORMATION. Bargaining Unit Employees FERRIS STATE UNIVERSITY HEALTH PLAN SUPPLEMENTAL INFORMATION Bargaining Unit Employees AFSCME Public Safety Officers Public Safety Supervisors Nurses Effective July 1, 2005 1247959-2 TABLE OF CONTENTS

More information

ARMSTRONG INTERNATIONAL, INC. THREE RIVERS MI

ARMSTRONG INTERNATIONAL, INC. THREE RIVERS MI ARMSTRONG INTERNATIONAL, INC. THREE RIVERS MI Dental Booklet Revised 01-01-2016 BENEFITS ADMINISTERED BY Table of Contents INTRODUCTION... 3 PLAN INFORMATION... 4 SCHEDULE OF BENEFITS... 6 OUT-OF-POCKET

More information

Cleveland Clinic. BeneFlex Program. Summary Plan Description

Cleveland Clinic. BeneFlex Program. Summary Plan Description Cleveland Clinic BeneFlex Program Summary Plan Description Calendar Year 2015 Table of Contents THE CLEVELAND CLINIC BENEFLEX PROGRAM About the Program..............................................................................

More information

for Small Groups Underwriting Guidelines Effective January 2014 For businesses with 2-50 employees, effective March 2010 lin no at of

for Small Groups Underwriting Guidelines Effective January 2014 For businesses with 2-50 employees, effective March 2010 lin no at of Steve Shorr Insurance Authorized Agent 310.519.1335 http://healthreformquotes.com/ is Th do e cu Se ay no at e rb ge n lo w of w w p to at e th ge pa k lin e om rh e th tm en m ou or th e tc os m nt re

More information

Benefits. Leave Benefits. Holidays

Benefits. Leave Benefits. Holidays Benefits The following benefits apply to full-time employees only, except for 403(b) retirement plans which are available for all employees. For retirement purposes, a full-time employee is defined as

More information

2017 EMPLOYEE BENEFITS GUIDE

2017 EMPLOYEE BENEFITS GUIDE 2017 EMPLOYEE BENEFITS GUIDE Medical Coverage ImmediaDent offers medical coverage through Blue Cross Blue Shield of Kansas City, a national healthcare company. Members have access to a nationwide network

More information

EXPLORING YOUR RETIREE HEALTHCARE BENEFITS THROUGH LACERA

EXPLORING YOUR RETIREE HEALTHCARE BENEFITS THROUGH LACERA EXPLORING YOUR RETIREE HEALTHCARE BENEFITS THROUGH LACERA TIER 1 AND TIER 2 RETIREE HEALTHCARE ADMINISTRATIVE GUIDELINES LOS ANGELES COUNTY EMPLOYEES RETIREMENT ASSOCIATION EXPLORING YOUR RETIREE HEALTHCARE

More information

Annual Benefits Enrollment is October 3 14, 2016.

Annual Benefits Enrollment is October 3 14, 2016. John Deere and You: Annual Benefits Enrollment for 2017 John Deere is committed to providing comprehensive, valuable, and affordable benefits to you and your family through our Healthy Directions program.

More information

Administrative Guide

Administrative Guide Administrative Guide Provided to assist you in the administration of your benefit plan Assurant Employee Benefits 2323 Grand Boulevard Kansas City, MO 64108 800.733.7879 Please Note: This administrative

More information

Health Savings Plan and Health Savings Account. Business Rules and Detailed Design Features for 2016

Health Savings Plan and Health Savings Account. Business Rules and Detailed Design Features for 2016 Health Savings Plan and Health Savings Account Business Rules and Detailed Design Features for 2016 i Table of Contents 1. Definition of Terms 1A High Deductible Health Plan 2 1B Health Savings Plan (HSP)

More information

Primary applicant s last name: First name: MI: Male Female Billing address: City: State: ZIP: County applicant resides in:

Primary applicant s last name: First name: MI: Male Female Billing address: City: State: ZIP: County applicant resides in: Application must be typed or completed in blue or black ink. Effective date of coverage: Coverage is only available for enrollment during the annual open enrollment period, which is November 1, 2015, through

More information

Benefit Program Information for Retirees

Benefit Program Information for Retirees Benefit Program Information for Retirees 2017 Plan Highlights To be eligible to retire and for continued health, dental and or vision coverage, retirees must be at least age 55 and have at least 10 years

More information

Healthcare Options for Veterans

Healthcare Options for Veterans Healthcare Options for Veterans January 2017 (This information was copied from Unit 3 of Module 4 in the 2017 WIPA Training Manual) Introduction The U.S. Department of Defense (DoD) and the Department

More information