October Renewal Date: January 1, Dear Blue Cross of Idaho Member,
|
|
- Easter Craig
- 5 years ago
- Views:
Transcription
1 October 2017 Renewal Date: January 1, 2018 Dear Blue Cross of Idaho Member, Thank you for choosing Blue Cross of Idaho for your health insurance needs. If you want to keep your current plan, you don t have to do a thing. We ll automatically renew your coverage effective on January 1, This packet includes important information about your insurance renewal. Please take some time to review these materials. Please note: We have not received High Risk Pool rates. Because of this, we entered a premium amount of $1 as a placeholder for these products. We will send you additional information as we receive it. A required healthcare reform notice with important renewal information. An Amendment to your policy effective with your renewal. A Policy Update outlining plan changes. Please read this information carefully. A copy of the Women s Health and Cancer Rights Act of 1998 notice. We understand that health insurance can be confusing. We are here to help when you need us. If you have questions about your plan, please call Blue Cross of Idaho customer service at Sincerely, Peter Morrissey Vice President of Sales Enclosures 0118 No Rate Ind Non QHP HRP Member Renewal
2 Dear Member: Your health insurance coverage will soon be due for annual renewal. You have the option to renew your current policy or choose a new health insurance plan. As you may be aware, the Affordable Care Act (ACA) requires all individuals to enroll in health insurance coverage that includes a specific set of benefits and consumer protections known as minimum essential coverage. Individuals who have minimum essential coverage are not subject to a tax penalty. The federal government has concluded that your current health insurance plan meets the minimum essential coverage standard. Therefore, if you renew your current plan, you will not be subject to a tax penalty when you file your federal tax return for 2017 and later years. However, in making your choice, you should remember the following. First, you have the option to enroll in a new health insurance plan that provides greater consumer protections and benefits. The ACA requires coverage for new health insurance plans to comply with the following: Individuals cannot be denied coverage based on a pre-existing medical condition. Health insurance premiums cannot be based on health factors, so you will not pay higher premiums because you have a health problem, need to see medical providers frequently, or have expensive health insurance claims. Insurance carriers cannot cancel your coverage if you get sick or become injured. There is no annual or lifetime dollar limits on how much your health insurance will pay for services considered essential health benefits. The out-of-pocket costs you pay other than monthly premiums are limited to an annual dollar amount. For 2017, individuals pay no more than $7,150 and 1
3 families will pay no more than $14,300. For 2018, individual out-of-pocket costs will be limited to $7,350 and family out-of-pocket costs to $14,700. There are two enrollment periods when you may choose a new plan: 1. You have a 120-day special enrollment period in which you may enroll in a new plan instead of renewing your current plan. This special enrollment period begins 60 days before the end of your current plan year, and lasts 60 days after it ends. It is important to enroll in the new plan by the 15th of the month before your current plan ends to avoid a break in coverage. 2. You also have the opportunity to enroll in a new plan during the annual fall enrollment period for coverage beginning in January of the following year. The annual enrollment period for 2018 coverage will begin November 1, 2017 and run through December 15, Second, by enrolling in a new health plan you may be able to pay lower monthly premiums and out-of-pocket costs. If you enroll in the new plan through Idaho s health insurance exchange, Your Health Idaho, you may be able to qualify for advance tax credits to help pay your monthly premiums, as well for additional assistance paying outof-pocket costs. For more information on Your Health Idaho, and to view health insurance plans available through your special enrollment period, please visit You may also enroll in a new health plan not sold on Your Health Idaho. If you enroll outside Your Health Idaho, you will not qualify for assistance in paying for your health insurance plan premium, but you will still have access to a wide selection of plans providing greater consumer protections which may cost less than your current plan. If you have questions on this letter, please contact us, your insurance agent or broker, or the Idaho Department of Insurance at , or at
4 AMENDMENT TO THE BLUE CROSS OF IDAHO INDIVIDUAL POLICIES Effective with your renewal, the following Blue Cross of Idaho Individual Policies shall be amended as follows: Idaho Basic Individual Policy Form No BASIC 2001 (01/01) Idaho Catastrophic A Individual Policy Form No CAT A 2001 (01/01) Idaho Catastrophic B Individual Policy Form No CAT B 2001 (01/01) Idaho Standard Individual Policy Form No STANDARD 2001 (01/01) Idaho HSA Individual Policy Form No (01/06) The Policy shall be amended as follows: 1. The How We Notify You language in the How to Submit Claims Section, shall be amended to read: BCI will send the Insured an Explanation of Benefits (EOB), either electronically or by mail, as soon the claim is processed. The EOB will show all the payments BCI made and to whom the payments were sent. It will also explain any charges BCI did not pay in full. Insureds should print the electronic copy and keep this EOB for their records. If you would like a paper copy of your EOB, you may request one from BCI Customer Service. 2. The Entire Policy-Changes section in the General Provisions Section shall be amended to include application in the list of items which form part of the Policy of insurance. 3. The Subrogation and Reimbursement Rights Of Blue Cross Of Idaho section shall be amended to the following in the General Provisions Section: The benefits of this Policy will be available to an Insured when he or she is injured, suffers harm or incurs loss due to any act, omission, or defective or unreasonably hazardous product or service of another person, firm, corporation or entity (hereinafter referred to as third party ). To the extent that such benefits for Covered Services are provided or paid for by Blue Cross of Idaho under this Policy or any other Blue Cross of Idaho plan, agreement, certificate, contract or policy, Blue Cross of Idaho shall be subrogated and succeed to the rights of the Insured or, in the event of the Insured s death, to the rights of his or her heirs, estate, and/or personal representative. As a condition of receiving benefits for Covered Services in such an event, the Insured or his or her personal representative shall furnish Blue Cross of Idaho in writing with the names, addresses, and contact information of the third party or parties that caused or are responsible, or may have caused or may be responsible for such injury, harm or loss, and all facts and information known to the Insured or his or her personal representative concerning the injury, harm or loss. In addition, the insured shall furnish the name and contact information of the liability insurer or its adjuster of the third party including the policy number of any liability insurance that covers, or may cover, such injury, harm, or loss. Blue Cross of Idaho may at its option elect to enforce either or both of its rights of subrogation and reimbursement. Subrogation is taking over the Insured s right to receive payments from other parties. The Insured or his or her legal representative will transfer to Blue Cross of Idaho any rights he or she may have to take legal action arising from the injury, harm or loss to recover any sums paid on behalf of the Insured. Thus, Blue Cross of Idaho may initiate litigation at its sole discretion, in the name of the Insured, against any third party or parties. Furthermore, the Insured shall fully cooperate with Blue Cross of Idaho in its investigation, evaluation, litigation and/or collection efforts in connection with the injury, harm or loss and shall do nothing whatsoever to prejudice Blue Cross of Idaho s subrogation rights and efforts. Blue Cross of Idaho will be reimbursed in full for all benefits paid even if the Insured is not made whole or fully compensated by the recovery. Moreover, Blue Cross of Idaho is not responsible for any attorney s fees or other expenses or costs incurred by the Insured without prior written consent of Blue Cross of Idaho and, therefore, the common fund doctrine does not apply to any amounts recovered by any attorney the Insured hires regardless of whether amounts recovered are used to repay benefits paid by Blue Cross of Idaho, or otherwise. Additionally, Blue Cross of Idaho may at its option elect to enforce its right of reimbursement from the Insured, or his or her legal representative, of any benefits paid from monies recovered as a result of the injury, harm or loss. The Insured shall fully cooperate with Blue Cross of Idaho in its investigation, evaluation, litigation and/or collection efforts in connection with the injury, harm or loss and shall do nothing whatsoever to prejudice Blue Cross of Idaho s reimbursement rights and efforts. Form No (01/18) Page 1 of 2
5 The Insured shall pay Blue Cross of Idaho as the first priority, and Blue Cross of Idaho shall have a constructive trust and an equitable lien on, all amounts from any recovery by suit, settlement or otherwise from any third party or parties or from any third party s or parties insurer(s), indemnitor(s) or underwriter(s), to the extent of benefits provided by Blue Cross of Idaho under this Policy, regardless of how the recovery is allocated (i.e., pain and suffering) and whether the recovery makes the Insured whole. Thus, Blue Cross of Idaho will be reimbursed by the Insured, or his or her legal representative, from monies recovered as a result of the injury, harm or loss, for all benefits paid even if the Insured is not made whole or fully compensated by the recovery. Moreover, Blue Cross of Idaho is not responsible for any attorney s fees or other expenses or costs incurred by the Insured without prior written consent of Blue Cross of Idaho and, therefore, the common fund doctrine does not apply to any amounts recovered by any attorney the Insured hires regardless of whether amounts recovered are used to repay benefits paid by Blue Cross of Idaho, or otherwise. Rights of subrogation and reimbursement extend to any right the Insured has to recover from the Insured s insurer, or under the Insured s Medical Payments coverage or any Uninsured Motorist, Underinsured Motorist, or other similar coverage provisions, and workers compensation benefits. Blue Cross of Idaho shall have the right, at its option, to seek reimbursement from, or enforce its right of subrogation against, the Insured, the Insured s personal representative, a special needs trust, or any trust, person or vehicle that holds any payment or recovery from or on behalf of the Insured including the Insured s attorney. Blue Cross of Idaho s subrogation and reimbursement rights shall take priority over the Insured s rights both for benefits provided and payments made by Blue Cross of Idaho, and for benefits to be provided or payments to be made by Blue Cross of Idaho in the future on account of the injury, harm or loss giving rise to Blue Cross of Idaho s subrogation and reimbursement rights. Further, Blue Cross of Idaho s subrogation and reimbursement rights for such benefits and payments provided or to be provided are primary and take precedence over the rights of the Insured, even if there are deficiencies in any recovery or insufficient financial resources available to the third party or parties to totally satisfy all of the claims and judgments of the Insured and Blue Cross of Idaho. Collections or recoveries made by an insured for such injury, harm or loss in excess of such benefits provided and payments made shall first be allocated to such future benefits and payments that would otherwise be owed by the Plan on account of the injury, harm or loss giving rise to Blue Cross of Idaho s subrogation and reimbursement rights, and shall constitute a Special Credit applicable to such future benefits and payments that would otherwise be owed by Blue Cross of Idaho under this or any subsequent Blue Cross of Idaho Plan or coverage. Thereafter, Blue Cross of Idaho shall have no obligation to provide any further benefits or make any further payments until the Insured has incurred medical expenses in treatment of such injury, harm, or loss equal to such Special Credit. Except as amended, the policy shall remain unchanged. This amendment is attached to and forms part of the policy issued to the Enrollees. In witness whereof, BLUE CROSS OF IDAHO HEALTH SERVICE, INC., by its duly authorized officer, has executed this amendment. Blue Cross of Idaho Health Service, Inc. PO Box 7408 Boise, ID Keith G. Bushardt Sr. Vice President, Sales & Customer Experience Form No (01/18) Page 2 of 2
6 POLICY UPDATES To Your Blue Cross of Idaho Individual Policy Please Read Carefully Dear Blue Cross of Idaho Enrollee: This Policy Update is a summary of the changes to your health insurance coverage effective on your Policy s renewal date. We encourage you to review this carefully. For reference, the words and terms capitalized in this document are defined in your member contract. How To Submit Claims Section Updates have been made to include that your Explanation of Benefits (EOB) can be received either electronically or by mail. You can print an electronic copy or contact Blue Cross of Idaho Customer Service to request a paper copy by mail. General Provisions Section The Entire Contract-Changes section has been updated to include application as a listed item of the Contract. The entire section of Subrogation and Reimbursement Rights of Blue Cross of Idaho has been replaced with new subrogation language. Please note: This Policy Update is only a brief highlight of the changes made by Blue Cross of Idaho Ind HRP
7
8 Important Notice The Women s Health and Cancer Rights Act of 1998 requires health plans and insurers to provide the following mastectomy-related services. 1. reconstruction of the breast on which the mastectomy/lumpectomy was performed; 2. surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3. prostheses and treatment of physical complications at all stages of the mastectomy/ lumpectomy, including lymphedemas. Benefits are subject to the standard surgical deductibles, copayments and coinsurance amounts of your policy. If you have any questions, please contact our customer service department at or the number on the back of your member ID card. Originated Form No (01-17) 3000 E. Pine Avenue, Meridian, ID P.O. Box 7408, Boise, ID (208) An Independent Licensee of the Blue Cross and Blue Shield Association
October Renewal Date: January 1, Dear Blue Cross of Idaho Member,
October 2017 Renewal Date: January 1, 2018 Dear Blue Cross of Idaho Member, Thank you for choosing Blue Cross of Idaho for your health insurance needs. If you want to keep your current plan, you don t
More informationOctober Renewal Date: January 1, Dear Blue Cross of Idaho Member,
October 2017 Renewal Date: January 1, 2018 Dear Blue Cross of Idaho Member, Thank you for choosing Blue Cross of Idaho for your health insurance needs. If you want to keep your current plan, you don t
More informationAMENDMENT TO YOUR CLOSED PANEL PPO AGREEMENT QCC INSURANCE COMPANY
AMENDMENT TO YOUR CLOSED PANEL PPO AGREEMENT QCC INSURANCE COMPANY This Notice of Change is issued to form part of your Benefit Booklet that describes Health Benefit Plan s or Claims Administrator s (as
More informationSupplemental Unemployment & Disability Plan of Local Union 370. June 2018
FLINT PLUMBING AND PIPEFITTING FRINGE BENEFIT FUNDS Flint Plumbing & Pipefitting Industry Health Care Fund Flint Plumbing & Pipefitting Industry Pension Fund Flint Plumbing & Pipefitting Industry Defined
More informationSUMMARY PLAN DESCRIPTION FOR THE UNIVERSITY OF PENNSYLVANIA RETIREE HEALTH PLAN
SUMMARY PLAN DESCRIPTION FOR THE UNIVERSITY OF PENNSYLVANIA RETIREE HEALTH PLAN Note: This booklet is only a summary of certain portions of the Plan. Only the Plan itself can give any person a right to
More informationAPPLICATION FOR ENROLLMENT
APPLICATION FOR ENROLLMENT The person completing this application should keep the copy labeled Employee Copy and carefully read the information on the reverse side regarding the Health Insurance Portability
More information1. Women s Health and Cancer Rights Act of 1998 (WHCRA)
Medical Coverage Policy Mastectomy Treatment, Breast Reconstruction and Mastectomy Hospital Stays Mandates EFFECTIVE DATE: 01 01 2019 POLICY LAST UPDATED: 10 16 2018 OVERVIEW This policy documents coverage
More informationApplication For Enrollment
Application For Enrollment Fields marked with an * are required fields. Any required information not completed may delay the processing of your application. EMPLOYEE INFORMATION DR. MR. MRS. MS. REV. HEALTH
More informationPACIFIC WESTERN TECHNOLOGIES, LTD. your employee benefits. at a glance
PACIFIC WESTERN TECHNOLOGIES, LTD. your employee benefits at a glance 2011 Eligibility If you are an employee working 32 hours a week or more, you are eligible for all benefits outlined in this summary.
More informationELIGIBILITY INFORMATION YOU NEED TO KNOW
EMPLOYEE BENEFITS PLAN YEAR 2017-2018 TABLE OF CONTENTS Eligibility Information You Need to Know 3 Medical Benefits / Premiums 4 Deductible Type / Alternative Prescription Drug Program 6 Arkansas Blue
More informationAPPLICATION FOR ENROLLMENT
An Independent Licensee of the Blue Cross and Blue Shield Association APPLICATION FOR ENROLLMENT The person completing this application should keep the copy labeled Employee Copy and carefully read the
More informationNovember Re: Con Edison Retiree Health Program Open Enrollment for Dear Retiree:
November 2018 Re: Con Edison Retiree Health Program Open Enrollment for 2019 Dear Retiree: Open enrollment for 2019 health-care benefits available to you under the Con Edison Retiree Health Program (Program)
More information«Member_Name» «Member_Address_Line_1» «Member_Address_Line_2» «Member_City», «Member_State» «Member_Zip»
*** October 2018 «Member_Name» «Member_Address_Line_1» «Member_Address_Line_2» «Member_City», «Member_State» «Member_Zip» Dear «Member_First», Subscriber ID#: «Subscriber_ID» Good News! We will automatically
More informationAPPLICATION FOR ENROLLMENT
APPLICATION FOR ENROLLMENT The person completing this application should keep the copy labeled Employee Copy and carefully read the information on the reverse side regarding the Health Insurance Portability
More informationLive a Healthy and Vibrant Life
2017 Annual Enrollment November 2 18, 2016 Medicare -Eligible Retirees DOW U.S. BENEFITS WHAT S NEW FOR 2017 Live a Healthy and Vibrant Life Your Dow retiree benefits support you in living a healthy and
More informationLos Rios Community College District 2017 Annual Health Plan Notices
f Los Rios Community College District 2017 Annual Health Plan Notices INCLUDED IN THIS PACKET Medicare Notice of Creditable Coverage Newborns and Mothers Health Protection Act Notice Women s Health and
More informationNon-Union. Health Plan Notices IMPORTANT NOTICE
Non-Union 2015 Health Plan Notices IMPORTANT NOTICE This packet of notices related to our health care plan includes a notice regarding how the plan s prescription drug coverage compares to Medicare Part
More informationNOTICE: Important Information about Your Health Coverage for 2017 You Must Choose a New Plan for Next Year
Maryland Health Connection P.O. Box 857 Lanham, MD 20703-0857 NOTICE: Important Information about Your Health Coverage for 2017 You Must Choose a New Plan for Next Year Dear
More informationSISC PPO 65+ Retiree Medical Coverage Form for Medical and Prescription Drug Benefits (Continuous enrollment in Medicare A&B required)
District Use Only District Name: SISC PPO 65+ Retiree Medical Coverage Form for Medical and Prescription Drug Benefits (Continuous enrollment in Medicare A&B required) SISC will automatically enroll member(s)
More informationCompliance Guide. Presented By:
2016-2017 Compliance Guide Presented By: 1 Introduction This booklet contains mandatory annual notices regarding your health and welfare benefit plans through Washington Odd Fellows Home for the plan year
More informationYOUR RIGHTS AFTER A MASTECTOMY
YOUR RIGHTS AFTER A MASTECTOMY DEPARTMENT DEPARTMENT OF LABOR LABOR N N U E IT IT D STATE S AM AM E RIC A OF U.S. Department of Labor Employee Benefits Security Administration f you have had a mastectomy
More informationSURA/JEFFERSON SCIENCE ASSOCIATES, LLC
SURA/JEFFERSON SCIENCE ASSOCIATES, LLC COMPREHENSIVE HEALTH AND WELFARE BENEFIT PLAN Summary Plan Description Amended and Restated Effective April 1, 2011 YOUR SUMMARY PLAN DESCRIPTION This document is
More informationAdvocate Health Care Network Disability Income Protection Summary of Benefits
Advocate Health Care Network Disability Income Protection Summary of Benefits (Amended and Restated as of July 1, 2017) What s Inside Introduction...3 Disability Case Management...4 Disability Council...4
More informationERISA SPD Information
ERISA SPD Information This section contains important information, required by the Employee Retirement Income Security Act of 1974 ( ERISA ), about your medical benefits. Plan Name/Identification The medical
More informationCOSTCO EMPLOYEE BENEFIT PROGRAM ANNUAL OPEN ENROLLMENT
COSTCO EMPLOYEE BENEFIT PROGRAM ANNUAL OPEN ENROLLMENT 2010-2011 Welcome to the 2010-2011 Annual Open Enrollment for the Costco Benefits Program. This guide provides you with the information necessary
More informationNOTICE: Renewal of Your Health Coverage Open Enrollment Starts Nov. 1
Maryland Health Connection P.O. Box 857 Lanham, MD 20703-0857 Dear , NOTICE: Renewal of Your Health Coverage Open Enrollment Starts Nov. 1
More informationEmployee Benefits Compliance Checklist for Large Employers
: Provided by [B_Officialname] Employee Benefits Compliance Checklist for Large Employers Federal law imposes numerous requirements on the group health coverage that employers provide to their employees.
More informationTHE PLUMBERS & PIPEFITTERS LOCAL UNION NO. 9 WELFARE FUND REIMBURSEMENT AND SUBROGATION CONSENT TO LIEN FORM
THE PLUMBERS & PIPEFITTERS LOCAL UNION NO. 9 WELFARE FUND REIMBURSEMENT AND SUBROGATION CONSENT TO LIEN FORM 1. If you or your dependent have the opportunity to recover monies in connection with an illness,
More informationELIGIBILITY (SPD, Pages 4-13) Eligibility for your Dependents (SPD, Pages 4-5)
SUMMARY OF MATERIAL MODIFICATIONS FOR THE US AIRWAYS, INC. HEALTH OPTIONS PLAN EIN/PN: 53-0218143/514 Section 104 of the Employee Retirement Income Security Act of 1974 ( ERISA ) directs the administrator
More informationImportant Notices About Your Benefits
PROUDLY SERVING UTAH PUBLIC EMPLOYEES 560 East 200 South» Salt Lake City, UT» 84102-2004» 801-366-7555 or 800-765-7347» www.pehp.org Important Notices About Your Benefits Several important notices about
More informationNORTH EAST INDEPENDENT SCHOOL DISTRICT CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
NORTH EAST INDEPENDENT SCHOOL DISTRICT CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements
More informationBOX ELDER COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
BOX ELDER COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Restatement TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements for our
More informationLOW T CENTER. Revised 01/01/ All Rights Reserved 2
LOW T CENTER EMPLOYEE BENEFITS PLAN ERISA WRAP SPD Revised 01/01/2017 1997-2017 All Rights Reserved 2 LOW T CENTER EMPLOYEE BENEFITS PLAN & ERISA WRAP SUMMARY PLAN DESCRIPTION PLAN PURPOSE Low T Center
More informationABOUT YOUR PARTICIPATION ACTIVE EMPLOYEES (SPD, Pages 1-14)
SUMMARY OF MATERIAL MODIFICATIONS FOR THE US AIRWAYS, INC. HEALTH BENEFIT PLAN EIN/PN: 53-0218143/501 Section 104 of the Employee Retirement Income Security Act of 1974 ( ERISA ) directs the administrator
More informationREMINDER OF REIMBURSEMENT OBLIGATION
REMINDER OF REIMBURSEMENT OBLIGATION Dear Participant: You recently submitted a claim form on which you indicated that you were injured in a non-work related accident. When the Fund pays benefits to you
More informationA Doctor in your house whenever you wish and now it s FREE!
SEPTEMBER 2018 A Doctor in your house whenever you wish and now it s FREE! Beginning Nov. 1, the co-pay for MDLive, Cigna's Telemedicine benefit, will be eliminated Through the Health Fund s MDLIVE benefit,
More informationRobert Bosch LLC. Retiree Welfare Benefit Plan. Summary Plan Description
Robert Bosch LLC Retiree Welfare Benefit Plan Summary Plan Description This Summary Plan Description (SPD) describes the Retiree Welfare Benefit Plan with benefits based on an April 1 March 31 Plan Year.
More informationAffordable Care Act Resource Guide
Affordable Care Act Resource Guide for Businesses with fewer than 50 employees Effective January 22, 2016 Form No. 3-1018 (02-16) The information in this document is a general overview of the rules, regulations
More informationERISA NOTICE REQUIREMENTS
ERISA NOTICE REQUIREMENTS ERISA AND OTHER REQUIRED NOTICES FOR GROUP HEALTH PLANS 369 North Main Street PO Box 299 Marlborough, CT 06447 888-322-2524 dgb-online.com ERISA and Other Required Notices Exchange
More informationMedical Coverage for Medicare- Eligible Participants
Medical Coverage for Medicare- Eligible Participants If you are an employee receiving benefits under a Long-Term Disability Plan (LTD) sponsored by the Company, and you or one of your covered dependents
More informationCement Mixer. The. Medicare Part D Creditable Coverage Retired Participants. Breast Cancer Risk Factors
www.norcalcementmasons.org Cement Mixer The A Quarterly Newsletter for Northern California Cement Masons Fall 2010 #46 Medicare Part D Creditable Coverage Retired Participants What Is Coordination Of Benefits?
More informationDOW U.S. BENEFITS WHAT S NEW FOR
2018 Annual Enrollment November 1 17, 2017 Medicare -Eligible Retirees DOW U.S. BENEFITS WHAT S NEW FOR 2018 Live a Healthy and Vibrant Life Your Dow retiree benefits support you in living a healthy and
More informationAffordable Care Act Resource Guide
Affordable Care Act Resource Guide for Businesses with 50 or more employees Effective January 22, 2015 Form No. 3-1019 (02-16) The information in this document is a general overview of the rules, regulations
More informationCITY OF GAINESVILLE, GEORGIA FLEXIBLE SPENDING BENEFITS PLAN SUMMARY PLAN DESCRIPTION
CITY OF GAINESVILLE, GEORGIA FLEXIBLE SPENDING BENEFITS PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements
More informationJanuary 1, 2017 C.A.R. Health Insurance Program. General Plan Guidelines
January 1, 2017 C.A.R. Health Insurance Program General Plan Guidelines C.A.R. Endorsed Agent: RealCare Insurance Marketing, Inc. 19310 Sonoma Highway, Ste. A Phone: (800) 939-8088 Fax: (707) 935-7142
More informationTOWN OF CANTON SECTION 125 CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
TOWN OF CANTON SECTION 125 CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements for our
More informationHealth Care FSA COBRA ELECTION NOTICE for the Health Care FSA offered through the Office of Group Benefits
Health Care FSA COBRA ELECTION NOTICE for the Health Care FSA offered through the Office of Group Benefits Date July 4, 2014 Dear: DEPENDENT OF NAME ADDRESS ANY CITY, LA 99999 Introduction This notice
More informationSUMMARY PLAN DESCRIPTION FOR MORA ISD 332
SUMMARY PLAN DESCRIPTION FOR MORA ISD 332 The Employee Retirement Income Security Act of 1974 (ERISA) requires that certain information be furnished to each participant or eligible participant in an employee
More informationOpen Enrollment. and Summary of Material Modifications. prepared for
2014 Open Enrollment and Summary of Material Modifications prepared for Medical, Dental, Vision, Disability, Life/AD&D, Flexible Spending Accounts, Employee Assistance Program 2014 Open Enrollment and
More informationUPDATE FUND THE IMPACT OF THE PENSION PROTECTION ACT INSIDE THIS ISSUE NEWS FROM ROAD CARRIERS LOCAL 707 WELFARE & PENSION FUND ~ JUNE 2008
FUND UPDATE NEWS FROM ROAD CARRIERS LOCAL 707 WELFARE & PENSION FUND ~ JUNE 2008 INSIDE THIS ISSUE Please note that there is important information about your rights under the Plan in this issue. Please
More informationParticipating in the Plan
This section provides an overview for participating in the Plan offered to eligible Bosch associates, such as elected and nonelected benefits, who is eligible, enrolling for benefits and when coverage
More informationHIRE UP STAFFING SERVICES HEALTH & WELFARE PLAN SUMMARY PLAN DESCRIPTION. December 1, Copyright ERISA Compliance Services, Inc.
HIRE UP STAFFING SERVICES HEALTH & WELFARE PLAN SUMMARY PLAN DESCRIPTION December 1, 2015 Copyright 2002-2016 ERISA Compliance Services, Inc. HIRE UP STAFFING SERVICES HEALTH & WELFARE PLAN SUMMARY PLAN
More informationC.A.R. Health Insurance Program. General Plan Guidelines. Effective December 1, 2018
DRAFT PENDING APPROVAL C.A.R. Health Insurance Program General Plan Guidelines Effective December 1, 2018 C.A.R. Endorsed Agent: RealCare Insurance Marketing, Inc. 430 West Napa Street, Suite F, Sonoma,
More informationGroup Administrator s Manual
Group Administrator s Manual An Independent Licensee of the Blue Cross and Blue Shield Association Form No. 3-402 (07-11) Table of Contents Phone Numbers and Addresses... 2 Who is Eligible for Healthcare
More informationPRIDE, INC. CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
PRIDE, INC. CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements for our Plan?... 2 3. When
More informationPlease read annual enrollment. Important changes are coming to the BP Retiree Medical Plan. October 24 November 4
Please read Important changes are coming to the BP Retiree Medical Plan. 2017 annual enrollment October 24 November 4 What s inside? 2 3 5 7 9 10 11 13 What s changing Compare your new coverage How it
More informationSUMMARY OF MATERIAL MODIFICATIONS FOR YEAR 2015
SUMMARY OF MATERIAL MODIFICATIONS FOR YEAR 2015 This notice summarizes the modifications to the NALC Health Benefit Plan for Employees and Staff (Staff Plan) effective January 1, 2015. This information
More informationEmployBridge Holding Company Associates Welfare Benefits Plan
EmployBridge Holding Company Associates Welfare Benefits Plan Summary Plan Description* *This document, together with the Certificate(s) and SPD Booklet(s) for the Benefit Program(s) in which you are enrolled,
More informationEmployee Benefits Compliance Checklist for Large Employers
Brought to you by Ardent Solutions Employee Benefits Compliance Checklist for Large Employers Federal law imposes numerous requirements on the group health coverage that employers provide to their employees.
More informationSYRACUSE UNIVERSITY MEDICAL BENEFITS PLAN SUMMARY PLAN DESCRIPTION
SYRACUSE UNIVERSITY MEDICAL BENEFITS PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS Page I. GENERAL INFORMATION... 1 II. OVERVIEW OF PLAN... 3 III. ELIGIBILITY... 3 IV. BENEFIT OPTIONS... 4 V. CLAIMS
More informationCOLBY COLLEGE STAFF HANDBOOK APPENDIX TABLE OF CONTENTS
COLBY COLLEGE STAFF HANDBOOK APPENDIX TABLE OF CONTENTS Appendix A (Benefit Plan Summary Plan Descriptions)...2 Life...2 Health...5 Long Term Disability...13 Medical Reimbursement...16 Retirement...19
More informationAffordable Care Act Toolkit
Affordable Care Act Toolkit for Businesses with 50 or more employees Choose coverage that fits. Form No. 3-1019 (07-14) The Affordable Care Act Blue Cross of Idaho prepared this toolkit to help you define
More informationIMPORTANT INFORMATION ABOUT ENROLLMENT
LOUDOUN COUNTY PUBLIC SCHOOLS DEPARTMENT OF BUSINESS & FINANCIAL SERVICES EMPLOYEE HEALTH, WELLNESS AND BENEFITS 21000 Education Court, Suite 319 Ashburn, VA 20148 Phone (571) 252-1810 Fax (571) 252-1401
More informationCITY COLLEGES OF CHICAGO Retiree Benefits OPEN ENROLLMENT. November 14, 2016 November 28, 2016
CITY COLLEGES OF CHICAGO 2017 Retiree Benefits OPEN ENROLLMENT November 14, 2016 November 28, 2016 Mark Your Calendars! Enrollment Form is Due NOVEMBER 28, 2016 NON-EARLY RETIREES & SURVIVING SPOUSES WWW.CCC.EDU
More informationSouthern Healthcare Agency Field Employees Summary of Benefits Blue Cross Blue Shield of MS
Southern Healthcare Agency Field Employees Summary of Benefits Blue Cross Blue Shield of MS Dual Option #1 Plan: Network Blue Deductible: $5000 Coinsurance: 70% Network/50% Non-Network Out of Pocket: $6450
More informationNORTHERN BURLINGTON COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
NORTHERN BURLINGTON COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?...1 2. What are the eligibility requirements for our Plan?...2
More informationOPEN ENROLLMENT GET READY! GET SET! GO! See page 6 for important information concerning Medicare Part D coverage.
OPEN ENROLLMENT 2015 GET READY! Your Dates To Enroll (Elections become effective January 1, 2015): October 20 - October 31, 2014 GET SET! It is time to review your benefit elections for the new Plan year.
More informationSUMMARY OF MATERIAL MODIFICATION
SUMMARY OF MATERIAL MODIFICATION TO: RE: ALL SOUND HEALTH & WELLNESS RETIREE TRUST PLAN PARTICIPANTS PLAN CHANGES This insert to your January 2009 Summary Plan Description (SPD) booklet describes changes
More informationChapter 1: What is the Affordable Care Act?
Chapter 1: What is the Affordable Care Act? The Affordable Care Act (ACA), also known as Obamacare, is a law that aims to help millions of Americans secure health insurance. Many individuals still are
More informationJOHNSON CITY SCHOOLS
JOHNSON CITY SCHOOLS Nondiscrimination Notice BlueCross BlueShield of Tennessee (BlueCross) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national
More informationPLURALSIGHT, LLC FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION
PLURALSIGHT, LLC FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?...1 2. What are the eligibility requirements for our Plan?...2
More informationRUSK INDEPENDENT SCHOOL DISTRICT FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION
RUSK INDEPENDENT SCHOOL DISTRICT FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION Updated September 18, 2012 TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What
More informationWESTERN PENNSYLVANIA ELECTRICAL EMPLOYEES INSURANCE TRUST FUND
WESTERN PENNSYLVANIA ELECTRICAL EMPLOYEES INSURANCE TRUST FUND NOTICE FOR COBRA COVERAGE If you are involuntarily terminated from employment between September 1, 2008 and December 31, 2009, and are eligible
More information2018 RETIREMENT PROGRAM
CITY COLLEGES OF CHICAGO 2018 RETIREMENT PROGRAM for Local 1600 Retirees and Surviving Spouses (Non-Subsidized) WWW.CCC.EDU 773-COLLEGE Medical Plans The purpose of the City Colleges of Chicago s medical
More informationOhio Public Employees Retirement System Summary Plan Description. Health Reimbursement Arrangement Plan
Ohio Public Employees Retirement System 2018 Summary Plan Description Health Reimbursement Arrangement Plan TABLE OF CONTENTS Page INTRODUCTION... 1 PLAN INFORMATION... 1 Name of the Plan... 1 The Plan
More informationCSD Insurance Trust. Important Health Plan Notices for Employees Premium and Standard Plans
CSD Insurance Trust Important Health Plan Notices for Employees Premium and Standard Plans October 1, 2013 Important Notice from the Cooperating School District Trust About Creditable Prescription Drug
More informationANNUAL NOTICE REGARDING MEDICARE PRESCRIPTION COVERAGE
INDIANA LABORERS WELFARE FUND P.O. BOX 1587 TERRE HAUTE, INDIANA 47808-1587 Telephone (812) 238-2551 Toll Free (800) 962-3158 Fax (812) 238-2553 www.indianalaborers.org October 2015 To All Participants
More informationGWINNETT COUNTY PUBLIC SCHOOLS FLEXIBLE BENEFIT PLAN
GWINNETT COUNTY PUBLIC SCHOOLS FLEXIBLE BENEFIT PLAN SUMMARY PLAN DESCRIPTION January 1, 2017 PLN 501 Copyright 2014 SunGard All Rights Reserved TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant
More informationNATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION SHORT-TERM DISABILITY PLAN. A Constituent Plan of the NRECA Group Benefits Program
NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION SHORT-TERM DISABILITY PLAN A Constituent Plan of the NRECA Group Benefits Program As Amended and Restated January 1, 2012 TABLE OF CONTENTS Page SECTION
More informationNow through December 21, 2018 is open enrollment to choose health and
1099Rs Will Be Mailed in Late January. Look for Yours! FOR YOUR BENEFIT UFCW Unions & Participating Employers Health & Welfare Fund December 2018 Vol. 34, No. 4 Shoppers Open Enrollment for Health and
More informationHEALTH FIRST HEALTH PLANS, INC US Highway 1 Rockledge, Florida CERTIFICATE OF HMO COVERAGE
HEALTH FIRST HEALTH PLANS, INC. 6450 US Highway 1 Rockledge, Florida 32955 CERTIFICATE OF HMO COVERAGE Please call (321) 434-5665 for assistance regarding claims and information about coverage Employer
More informationTHE SCHOOL DISTRICT OF SPRINGFIELD R-12 SECTION 125 PLAN SUMMARY PLAN DESCRIPTION
THE SCHOOL DISTRICT OF SPRINGFIELD R-12 SECTION 125 PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements
More informationALLEGHENY COLLEGE. Summary Plan Description
ALLEGHENY COLLEGE Summary Plan Description For the Allegheny College Health & Welfare Employee Benefit Plan Amended and Restated Effective July 1, 2013 This document with the attached documents listed
More informationThis part of your plan does not apply to your plan of Managed DentalGuard dental care expense insurance.
This part of your plan does not apply to your plan of Managed DentalGuard dental care expense insurance. Your Managed DentalGuard dental care expense insurance policy appears later in this document. 00533014/00002.0/P44535/PRINT
More informationCommercial Insurance
covers medical expenses of individuals and groups Types of benefits and policies vary Group vs. Individual coverage Regulated by individual states 2 1 Fee-for-Service Types of Coverage High-Risk pools
More informationFrequently Asked Questions For Berklee Students Student Health Insurance Plan
Frequently Asked Questions For Berklee Students 2017-2018 Student Health Insurance Plan Table of Contents How do I?... 2 Insurance Plan Benefits... 4 What is covered under the Student Health Insurance
More informationCRC BENEFITS OPEN ENROLLMENT Now through November 15th NEW PLANS FOR In This Issue
CRC BENEFITS November News 2017 2018 OPEN ENROLLMENT Now through November 15th Medical and Dental Plans CRC partners with employees to provide comprehensive, affordable medical coverage by paying approximately
More information"Motor vehicle liability policy" defined. (a) A "motor vehicle liability policy" as said term is used in this Article shall mean an
20-279.21. "Motor vehicle liability policy" defined. (a) A "motor vehicle liability policy" as said term is used in this Article shall mean an owner's or an operator's policy of liability insurance, certified
More informationWe Make it Easy to Provide Your Employees With a Complete Benefits Package.
This coverage is not insurance and the Idaho AGC Self-funded Benefit Trust does not participate in the state Guarantee Association. We Make it Easy to Provide Your Employees With a Complete Benefits Package.
More informationRelationship (spouse, daughter, son, etc..)
Van Dyke Public Schools Benefits Open Enrollment Form Print Name DUE IN THE PERSONNEL OFFICE BY NOVEMBER 16, 2018 (586) 758-8337 or shelton.edie@vdps.net Union Building Please read instructions below before
More informationLIBERTY INSURANCE UNDERWRITERS INC.
LIBERTY INSURANCE UNDERWRITERS INC. (hereinafter called the Company ): In consideration of and subject to the payment of the premium, the agreement of the Named Insured to pay the Deductible amount stated
More informationFlexible Benefits Plans
Flexible Benefits Plans Summary of Material Modification Effective January 1, 2017 Changes to the Plan and Summary Plan Description (SPD) for Colgate University s Flexible Benefits Plan are described below.
More informationPrime 65. Benefit Guide. Form No (11-15)
2016 Benefit Guide Form No. 3-023 (11-15) Policy Form No. 3-020 (06-10) Policy Form No. 3-021 (06-10) Policy Form No. 3-022 (06-10) Policy Form No. 3-030 (06-10) Policy Form No. 3-031 (06-10) Policy Form
More informationCOBRA Continuation Coverage. Newborns and Mothers Health Protection Act (NMHPA) Women s Health and Cancer Rights Act (WHCRA) Networks/Claims/Appeals
Newborns and Mothers Health Protection Act (NMHPA) A health plan which provides benefits for pregnancy delivery generally may not restrict benefits for a covered pregnancy Hospital stay (for delivery)
More informationHealth Care Reform: Legislative Brief Important Effective Dates for Employers and Health Plans
Health Care Reform: Legislative Brief Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into
More informationTHE MCCLATCHY COMPANY COMPREHENSIVE WELFARE BENEFIT AND CAFETERIA PLAN SUMMARY PLAN DESCRIPTION. (Amended and Restated Effective January 1, 2014)
THE MCCLATCHY COMPANY COMPREHENSIVE WELFARE BENEFIT AND CAFETERIA PLAN SUMMARY PLAN DESCRIPTION (Amended and Restated Effective January 1, 2014) TABLE OF CONTENTS Page Section 1. Introduction... 3 Section
More informationSUMMARY PLAN DESCRIPTION * FOR THE TUSCOLA COUNTY MEDICAL CARE FACILITY TUSCOLA COUNTY MEDICAL CARE FACILITY EMPLOYEE BENEFITS PLAN
[INSURED] SUMMARY PLAN DESCRIPTION * FOR THE TUSCOLA COUNTY MEDICAL CARE FACILITY TUSCOLA COUNTY MEDICAL CARE FACILITY EMPLOYEE BENEFITS PLAN EFFECTIVE APRIL 1, 2018 NON-UNION EMPLOYEES THIS DOCUMENT SHOULD
More informationADRIAN PUBLIC SCHOOLS CAFETERIA PLAN SUMMARY PLAN DESCRIPTION. Amended as of January 1, 2017
ADRIAN PUBLIC SCHOOLS CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Amended as of January 1, 2017 TABLE OF CONTENTS I ELIGIBILITY...1 Page 1. When can I become a participant in the Plan?...1 2. What are the
More informationWant to Take Charge of Your Health Care?
Want to Take Charge of Your Health Care? BlueEdge HSA May Be the Solution SM What Is BlueEdge HSA? In today s rapidly changing health care landscape, more and more people are searching for health insurance
More informationThe Guardian Life Insurance Company of America. A Mutual Company Incorporated 1860 by the State of New York 7 Hanover Square New York, New York 10004
The Guardian Life Insurance Company of America A Mutual Company Incorporated 1860 by the State of New York 7 Hanover Square New York, New York 10004 INDIVIDUAL DENTAL INSURANCE POLICY POLICYOWNER: Refer
More information