WP2017 Retiree Index

WP-2017 Retiree Index

2017 INFORMATION FOR

 

 

The information provided herein is a summary of a portion of our benefits plans.  Should there be a discrepancy between this information and the Medical Summary Plan Description (SPD) or specific contracts for benefits, the SPD or contracts prevail.

 

 

If you cannot find the answers to your questions after reviewing the items below, please contact Lucas.Deborah@brevardschools.org  or call (321)-633-1000, extension 648.   

 

To review your benefits at any time, click here: www.easybenefits.com

 

The information provided herein is a summary of a portion of our benefits plans.  Should there be a discrepancy between this information and the Summary Plan Description (SPDs) or specific contracts for benefits, the SPDs or contracts prevail.

 

 

PLANS INFORMATION MISCELLANEOUS INFORMATION

Medical 

 

Pharmacy 

 

Dental  *Note New Dental Company for 2017

 

Vision 

 

Life Insurance

 

  

 

FORMS

 

Authorization for Release of Health
Information
 
 

 

Benefits Enrollment Form

 

Life Enrollment Form

 

Affidavit for Spouse

 

Affidavit Age 26-30 Dependent for OE 2017

 

Retiree Beneficiary Change Form

 

Retiree FRS - TASC Deduction Authorization Form

 

 

 

Medical Appeal Process

 

Benefits Guidebook

 

CMS (Medicare) Secondary Payer to CIGNA

 

Creditable Coverage Disclosure Notice - Medicare

 

Flu Vaccination Participating Pharmacies

 

Preferred Health Centers Listing

  

Procedures for Retiring Employees

 

Retiree Benefit Rates

 

Vendor Phone Numbers & Websites

 


FSRBC - 65 AND OVER

UNDER 65 WITH MEDICARE

If you are a retireee who is 65 and over,

please contact FBMC at 1-855-443-7722

Monday-Friday 7 a.m - 7p.m. OR visit them online at www.myfbmc.com.

 

 

 NOTE: 

Humana Dental Group Number 35974   

  

Each of the items below were discussed in the

Retiree Open Enrollment briefing as part of the

overall presentation.  

 

 

 

 

United Healthcare Plans

 

  

 

Health First Plans

  

 

 

MAIL OUTS 2017

 

Retiree Postcard Mailed

 

Open Enrollment Password and Instruction Letter

Retiree Enrollment Form

Affidavit - Dependent 26-30 (non-disabled)

Spousal Affidavit

DHMO Dental Facility Listing

TASC - FRS Deduction Authorization

Health Risk Assessment

 

 

 

2017 INFORMATION 

Retiree Open Enrollment Presentation for 2017 

 

 

 

 

 

  

 

 

 

  

 

 

 

 

Benefits Homepage