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HealthState PPO HMO
Life InsuranceDentalVisionSupplemental |
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Forms and Publications
Click on any of the links below to view or print a copy of the materials and forms related to your health care benefits. If you have questions about the benefits available to you, contact the insurance company directly. For help using People First, call (866) 663-4735. People First representatives are available from 8:00 a.m. to 6:00 p.m. Eastern time, Monday through Friday.
If you choose to fax your forms to the Service Center, you must complete this fax cover sheet.
Forms
| To enroll or make changes for 2010 | To claim benefits … |
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Health |
Health |
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Group Life |
FSAs and HSAs |
Publications for the 2010 Plan Year
| General Benefits Information for 2010 | FSA/HSA Reference Guides |
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| State Employees' Group Health PPO Plan | Life Insurance Brochure |
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| HMO Certificate of Coverages | |
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Upon retirement, you can continue dental and vision coverage through COBRA for up to 18 months. After 18 months, you may convert to a private policy by contacting the insurance company directly. |
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| Dental and Vision Brochures for 2010 | |
To convert your current supplemental policy, contact the insurance company directly. |
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| Additional Supplemental Brochures for 2010 | |
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