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Benefit Guide - AZ

2017 Benefit Guide ADOA Contacts Benefit Services Division 100 N. 15th Ave #260 Phoenix, AZ 85007 or Fax Benefit Options Wellness Employee Assistance Program Medical Plans Aetna Policy Number 476687 Payflex Blue Cross Blue Shield of Arizona Policy Number 30855 Cigna Policy Number 3331993 UnitedHealthcare Policy Number 705963 Pharmacy Plan MedImpact Vision Plan Avesis, Inc. Advantage Plan Policy Number 11001-2178 Plan Number 938 Discount Plan Policy Number 10000-4 Plan Number 9900 Dental Plans Delta Dental of Arizona Policy Number 77777-0000 Total Dental Administrators Health Plan, Inc. (TDAHP) Policy Number 680100 Flexible Spending Accounts ASI Life & Short-Term Disability Plans The Hartford Policy Number 395211 Long-Term Disability Plans Broadspire Services, Inc.

Page| 2017 enefit Guide 1 This guide describes the comprehensive benefits package “enefit Options” offered by the State of

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ADOA Benefit Options 2018 Benefit Guide Retired Employees

benefitoptions.az.gov

• Converting your group Life coverage to your own individual policy. • Porting your Life coverage which continues as a term life policy. To be eligible for portability, you must

  Your

SUBMITTING A CHANGE REQUEST - Benefit …

benefitoptions.az.gov

SUBMITTING A CHANGE REQUEST Requested benefit changes must be submitted in writing to ADOA Benefit Services Division within 31 calendar days of the event. EFFECTIVE DATE OF THE CHANGE

  Change, Request, Submitting, Submitting a change request

Benefit Guide Active Employees

benefitoptions.az.gov

Active Employees A. All active employees regularly scheduled to work 20 hours or more per week for at least 90 days or longer (except those listed below as ineligible), or a seasonal, temporary, or variable hour employee that has been

  Active, Employee, Active employees

INSTRUCTIONS FOR SUBMITTING A NEW …

benefitoptions.az.gov

INSTRUCTIONS FOR SUBMITTING A NEW RETIREMENT APPLICATION To enroll in ADOA - Benefit Options retiree benefits, fill out the blue "2018 Benefit Options Enrollment Form-Retiree/LTD" form on the other side of this page.

  Applications, Retirement, Submitting, Submitting a new, Submitting a new retirement application

INSTRUCTIONS - Benefit Options-Home

benefitoptions.az.gov

I hereby certify, under penalty of perjury, that the information I have provided in this application for employee benefits, i ncluding address and spouse

  Instructions, Benefits

ELIGIBLE RETIREES - Benefit Options-Home

benefitoptions.az.gov

SUBMITTING A NEW RETIREMENT APPLICATION ELIGIBLE RETIREES The following persons are eligible to participate in the Arizona Benefit Options program:

  Eligible, Retiree, Eligible retirees

OPEN ENROLLMENT 2018 - Benefit Options-Home

benefitoptions.az.gov

2 AGENDA • Open Enrollment Dates/Expos • Benefit Changes • Medical Flexible Debit Card • Tuition Discounts • Doctor on Demand • Wellness Update • Operations Update

  Open, Benefits, 2018, Enrollment, 2018 open enrollment

STATE OF ARIZONA LIMITED FLEXIBLE SPENDING …

benefitoptions.az.gov

benefit options-revised 06/24/15 state of arizona limited flexible spending accounts 2015 enrollment form new employee termination special enrollment qualified life

  Form, Limited, Employee, Account, Flexible, 2015, Arizona, Spending, Enrollment, Arizona limited flexible spending, Arizona limited flexible spending accounts 2015 enrollment form

HSA Preventive Drug List - 2018 - AZ

benefitoptions.az.gov

MedImpact Healthcare Systems, Inc. pbm.medimpact.com Copyright © 2017 MedImpact Healthcare Systems, Inc. All rights reserved. HSA Preventive Drug List - 2018 …

  Drug, Lists, 2018, Preventive, Hsa preventive drug list 2018

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2018 Benefit Guide State Members 832 Weathered Rock Court Jefferson City, MO 65101 800-487-0771 573-751-0771 www.mchcp.org myMCHCP

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Taxable Fringe Benefit Guide - Internal Revenue …

www.irs.gov

As a supplement to other IRS publications, the Taxable Fringe Benefit Guide is designed to help individuals responsible for determining the correct tax treatment of employee fringe

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2017 -2018 GIC Benefit Decision Guide FOR …

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See inside for benefit changes. GIC Benefit Decision Guide 2017-2018 FOR COMMONWEALTH OF MASSACHUSETTS MUNICIPAL Employees, Retirees and Survivors Benefits and Rates Effective July 1, 2017

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Michigan Department of Health and Human Services . BENEFIT PLANS* 01/08/2018 Page 2 of 11 . Benefit Plan ID Benefit Plan Name Benefit Plan Description Type

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caconstruction.net

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etf.wi.gov

You are only eligible for a separation benefit if you are: • Under age 55 (50 if protective);

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