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INSTRUCTIONS FOR SUBMITTING A NEW …
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.
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STATE OF ARIZONA LIMITED FLEXIBLE SPENDING …
benefitoptions.az.govbenefit options-revised 06/24/15 state of arizona limited flexible spending accounts 2015 enrollment form new employee termination special enrollment qualified life
OPEN ENROLLMENT 2018 - Benefit Options-Home
benefitoptions.az.gov2 AGENDA • Open Enrollment Dates/Expos • Benefit Changes • Medical Flexible Debit Card • Tuition Discounts • Doctor on Demand • Wellness Update • Operations Update
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
INSTRUCTIONS - Benefit Options-Home
benefitoptions.az.govI hereby certify, under penalty of perjury, that the information I have provided in this application for employee benefits, i ncluding address and spouse
SUBMITTING A CHANGE REQUEST - Benefit …
benefitoptions.az.govSUBMITTING 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
ELIGIBLE RETIREES - Benefit Options-Home
benefitoptions.az.govSUBMITTING A NEW RETIREMENT APPLICATION ELIGIBLE RETIREES The following persons are eligible to participate in the Arizona Benefit Options program:
HSA Preventive Drug List - 2018 - AZ
benefitoptions.az.govMedImpact Healthcare Systems, Inc. pbm.medimpact.com Copyright © 2017 MedImpact Healthcare Systems, Inc. All rights reserved. HSA Preventive Drug List - 2018 …
Benefit Guide Active Employees
benefitoptions.az.govActive 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
Benefit Guide - AZ
benefitoptions.az.govPage| 2017 enefit Guide 1 This guide describes the comprehensive benefits package “enefit Options” offered by the State of
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STATE OF TENNESSEE GROUP INSURANCE …
www.tn.gov- 3 - Special Enrollment Qualifying Events The federal law, Health Insurance Portability Accountability Act (HIPAA), allows you and your dependents to enroll in health coverage under certain conditions.