Employee Benefit Guide 2012 - City of Oklahoma City

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CHIP Notification Medicaid and the Children’s Health Insurance Program (CHIP) If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. OKLAHOMA – Medicaid Web site: http://www.insureoklahoma.org Phone: 1-888-365-3742 66
American Fidelity Privacy Notice PRIVACY AT AMERICAN FIDELITY ASSURANCE COMPANY At American Fidelity, we understand the importance of protecting your non-public personal information. We respect your privacy and share your concern. Your privacy is as important to us as it is to you. Since we are an insurance company, we may collect and receive certain personal, non-public information from customers, prospective customers and service providers on a daily basis. Our handling and protection of personal, non-public information is governed by a range of state and federal laws and regulations. Information you may consent to provide using the Internet is afforded the same protection as it would be if you provided it in writing, by phone or in conversation with one of our representatives. We collect, retain and share personal information only for particular business-related purposes and only as authorized by state and federal law. We may use your information to protect, service and administer your records, accounts and funds. It may be used, when necessary, to comply with certain laws and regulations. We may also use some information to help design new or improved products and services. Most importantly, any information that you may agree to provide helps us better understand your financial and insurance needs so we can continue to provide you high quality products and services. It is our goal to demonstrate American Fidelity’s commitment to your privacy and describe our policy for collecting, safeguarding and administering your personal information. We hope this information addresses your concerns. If you have further questions or comments about American Fidelity’s Privacy Policy, please contact AFA’s Privacy Advocate at 866-55-HIPAA (866-554-4722). 67
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Employee Benefit Guide 2012
Page 3:
Table of Contents 2012 Benefits Enr
Page 6 and 7:
City Benefits Program Eligibility &
Page 8 and 9:
Enrollment Schedule for Plan Year 2
Page 10 and 11:
Three Easy Ways to Enroll Enroll O
Page 12 and 13:
Your Benefit Design Structuring You
Page 15 and 16: INSURANCE PLANS Health Plan Benefit
Page 17 and 18: Health Plan Benefits Comparison Pla
Page 19 and 20: Health Plan Benefits Comparison Com
Page 21 and 22: HMO Plan UnitedHealthcare All servi
Page 23 and 24: Dental Plan BlueCross BlueShield of
Page 25 and 26: Vision Care Plan VSP Your VSP Visio
Page 27 and 28: Group Term Life Insurance and AD&D
Page 29 and 30: Individual Term Life Insurance Amer
Page 31: Cancer Insurance Limited Benefit Ca
Page 34 and 35: Flexible Spending Accounts American
Page 36 and 37: Flexible Spending Accounts American
Page 38 and 39: Flexible Spending Accounts FSA Work
Page 41 and 42: SPECIAL CITY BENEFITS Employee Assi
Page 43 and 44: Employee Assistance Program Allianc
Page 45: IRC 457 Deferred Compensation IRC 4
Page 48 and 49: Dependent Eligibility Requirements
Page 50 and 51: Important Benefit Plan Information
Page 52 and 53: Important Benefit Plan Information
Page 54 and 55: Continuation of Coverage (COBRA) CO
Page 56 and 57: Guide to Qualifying Changes in Stat
Page 58 and 59: Definitions Allowed Amount: Maximum
Page 60 and 61: Definitions Pre-existing Condition:
Page 63 and 64: IMPORTANT NOTIFICATIONS Medicare Di
Page 65: Medicare Disclosure For More Inform
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Employee Benefit Guide 2012 - City of Oklahoma City

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