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Cost Estimators Contacts Forms and Publications

Medical

PPO

HMO

Dental

Life Insurance

Minnesota Life Insurance

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 8:30 a.m. to 5:30 p.m. Eastern time, Monday through Friday.

Forms

To enroll or make changes for 2010

To enroll or make changes for 2009

To claim benefits …

Health

FSAs and HSAs

Group Life

Supplemental Benefits

Publications for the 2010 and 2009 Plan Year

General Benefits Information for 2010	General Benefits Information for 2009	FSA/HSA Reference Guide
Benefits Guide for Active State Employees Employee Enrollment Readiness Checklist Benefits Guide for Retirees Retiree Enrollment Readiness Checklist Retiree Benefits Package Retiree Rate Chart Medicare Part D Notice of Creditable Coverage for State Employees HIPAA Privacy Notice Authorization to Use and/or Disclose Personal Health Information Form Guide on Generics Guide on Weather Emergencies Guide to Improve Health Guide to Mail Service Guide When Seeing Doctor	Benefits Guide for Active State Employees Employee Enrollment Readiness Checklist Benefits Guide for Retirees Retiree Benefits Package Retiree Rate Chart Medicare Part D Notice of Creditable Coverage for State Employees' HIPAA Privacy Notice Authorization to Use and/or Disclose Personal Health Information Form Guide on Generics Guide on Weather Emergencies Guide to Improve Health Guide to Mail Service Guide When Seeing Doctor	2010 Tax-Favored Accounts (FSA/HSA) 2009 Tax-Favored Accounts (FSA/HSA)
State Employees' Group Health PPO Plan		Life and Disability Insurance Brochures
PPO Plan Booklet and Benefits Document Effective January 1, 2010 (Coming Soon) PPO Plan Booklet and Benefits Document Effective January 1, 2007 PPO Plan Summary of Plan Description Material Modification Effective January 1, 2009 PPO 2010 Open Enrollment Brochure PPO 2009 Open Enrollment Brochure RxBenefits at a Glance (Standard PPO) RxBenefits at a Glance (Health Investor PPO)		Minnesota Life Brochure SMS/SES Disability Insurance Brochure

HMO Certificate of Coverages
AvMed Health Investor Plan Effective January 1, 2006 AvMed Standard Health Plan Effective January 1, 2007 Capital Health Plan Effective January 1, 2006 Florida Health Care Plan Effective January 1, 2006 United Healthcare Standard Plan Effective January 1, 2008 United Healthcare Health Investor Plan Effective January 1, 2008 Vista Healthplan Effective January 1, 2006
Dental and Vision Brochures for 2010	Dental and Vision Brochures for 2009
Ameritas Indemnity with PPO Assurant Prepaid/Indemnity with PPO CIGNA Prepaid CompBenefits Prepaid (Network Plus)/PPO CompBenefits Prepaid (Select 15)/Indemnity UnitedHealthcare Prepaid (Solstice S700) Humana Vision	Ameritas Indemnity with PPO Assurant Prepaid/Indemnity with PPO CIGNA Prepaid CompBenefits Prepaid (Network Plus)/PPO CompBenefits Prepaid (Select 15)/Indemnity UnitedHealthcare Prepaid (Solstice S700) Humana Vision
Additional Supplemental Brochures for 2010	Additional Supplemental Brochures for 2009
AFLAC Brochure Alta Brochure Colonial Life Brochure Philadelphia American Life Brochure	AFLAC Brochure Alta Brochure Colonial Life Brochure Philadelphia American Life Brochure