Employee Insurance Information Booklet
Table of Contents
The following links reference the above PDF file.
1. Introduction to Select Benefits
- 1.1 The Select Benefits Plan
- 1.2. Benefit Year
- 1.3. Who is Covered
- 1.4. Benefit Credits/Premiums
- 1.5. Electing Coverage
- 1.6. Default Plan
- 1.7. Changing Coverage
- 1.8. When Coverage Begins
- 1.9. When Coverage Ends
- 1.10. Submitting Claims
- 1.11. Receipt of Documents
- 1.12. Future of the Plan
2. Health Plan
- 2.1. Benefit Summary
- 2.2. Introduction
- 2.3. When Health Coverage Begins
- 2.4. When Health Coverage Ends
3. Medical Benefits
- 3.1. About the Medical Plans
- 3.2. How Medical Benefits Are Paid
- 3.3 Covered Medical Expenses
- 3.4. Medical Expenses Not Covered
- 3.5. Individual Case Management
- 3.6. Patient Auditor Program
4. Dental Benefits
- 4.1. About the Dental Plans
- 4.2. Covered Dental Services
- 4.3. Preventive Plan
- 4.4. Standard Plan
- 4.5. Premium Plan
- 4.6. Dental Services Not Covered
5. Vision Plan
- 5.1. About The Vision Plans
- 5.2. Standard Plan
- 5.3. Managed Care Vision Plan
- 5.4. Vision and Optical Services Not Covered
6. Audio Plan
7. How to File a Claim
- 7.1. Required Claim Form Submission
- 7.2. Claim Filing Deadline
- 7.3. Hospital Services
- 7.4. Physician and Other Provider Services
- 7.5. Dental Services
- 7.6. Vision Services
- 7.7. Audio Services
- 7.8. Prescription Drugs
- 7.9. Medical Benefits
- 7.10. Other Claim Filing Tips
- 7.11. Benefit Payments
- 7.12. Before Filing a Claim
- 7.13. Recordkeeping
- 7.14. Physical Examinations
- 7.15. If a Claim is Denied
8. Continued Health Coverage
- 8.1. Introduction
- 8.2. Length of Continued Coverage
- 8.3. Electing Coverage
- 8.4. Premium Payment
- 8.5. When Continuation Ends
- 8.6. Disabled Employees or Dependents
9. General Provisions – Health Benefits
- 9.1. Coordination of Benefits
- 9.2. Reimbursement Provision
- 9.3. Access to Records
- 9.4. Applicable Law and Venue
- 9.5. Cancellation
- 9.6. Changes to the Plan
- 9.7. Contract Liability
- 9.8. Epidemics and Public Disasters
- 9.9. Evidence of Medical Necessity
- 9.10. Facility of Payment
- 9.11. Free Choice of Hospital and Physician
- 9.12. Adequate Notice
- 9.13. Plan Must Be Effective
- 9.14. Medical Outcomes
- 9.15. Premiums
- 9.16. Prior Coverage
- 9.17. Right of Recovery
- 9.18. Right to Receive and Release Necessary Information
- 9.19. Transfer of Benefits, Assignment, Garnishment and Attachment
- 9.20. Vested Rights
10. Health Flexible Spending Account (HFSA)
11. Life Insurance
- 11.1. Introduction
- 11.2. Amount of Coverage
- 11.3. Your Beneficiary
- 11.4. Waiver of Premium With Disability
- 11.5. Assignment of Policy
- 11.6. Conversion Privilege
12. Accidental Death and Dismemberment (AD&D) Plan
- 12.1. Introduction
- 12.2. Who May Be Covered
- 12.3. Amount of Coverage
- 12.4. Your Beneficiary
- 12.5. Exclusions
13. Survivor Benefits
- 13.1. Introduction
- 13.2. Amount of Coverage
- 13.3. Your Beneficiary
- 13.4. Waiver of Premium With Disability
- 13.5. Conversion Privilege
14. Disability Benefits
- 14.1. Introduction
- 14.2. About the Plans
- 14.3. Short-Term Disability Plan
- 14.4. Long-Term Disability Plan
15. Dependent Care Assistance Plan (DCAP)
- 15.1. Introduction
- 15.2. How the Plan Works
- 15.3. Use It or Lose It
- 15.4. Eligible Dependents
- 15.5. Eligible Expenses
- 15.6. Limitations and Exclusions
- 15.7. If Your Spouse is Unemployed, a Student, or Incapable of Self-Care
- 15.8. IRS Reimbursement Limitations
- 15.9. Benefits Can Be Taxable
- 15.10. Reimbursement Plan Versus Tax Credit
- 15.11. Budgeting For Your Plan
- 15.12. Submitting Claims For Reimbursement
- 15.13. Future of the Plan
16. Group Life Plans
- 16.1. Basic Life and AD&D
- 16.2. Optional Life and AD&D Coverage
- 16.3. Payment Examples
- 16.4. When Coverage Ends
- 16.5. How to Continue Coverage
17. Travel Accidental Death and Dismemberment
- 17.1. Who is Covered
- 17.2. When Coverage Begins and Ends
- 17.3. Amount of Coverage
- 17.4. Travel Accident Exclusions
18. General Provisions – Optional Benefits
- 18.1. Applicable Law and Venue
- 18.2. Assignment
- 18.3. Beneficiary
- 18.4. Cancellation
- 18.5. Clerical Error
- 18.6. Conversion
- 18.7. Entire Contract
- 18.8. Facility of Payment
- 18.9. Incontestability
- 18.10. Misstatement of Age
- 18.11. Notice of Death
- 18.12. Payment of Claims
- 18.13. Right of Examination
- 18.14. Waiver of Premium with Permanent Total Disability