2023 Open Enrollment Booklets

2023 Employee Open Enrollment Booklet 
2023 Retiree Open Enrollment Booklet 
2023 Legislator Open Enrollment Booklet 

 

2022 Open Enrollment Booklets

2022 Employee Open Enrollment Booklet 
2022 Retiree Open Enrollment Booklet 
2022 Legislator Open Enrollment Booklet 

 

2021 Open Enrollment Booklets

2021 Employee Open Enrollment Booklet
2021 Retiree Open Enrollment Booklet
2021 Legislator Open Enrollment Booklet

  

Employee Benefit Books

 

Retiree Benefit Books

 

Legislator Benefit Books

 

Wrap Plan Documents

• Wrap Plan Document - Effective 1/1/2023 - Coming Soon
• Wrap Plan Document - Effective 1/01/2022 - 12/31/22
• Wrap Plan Document - Effective 1/01/2019 - 12/31/2021
•   

Medical Summary of Benefits and Coverage (SBC)

Summary of Benefits and Coverage (SBC) - Effective 1/1/2023 
Summary of Benefits and Coverage (SBC) - Effective 1/1/22 - 12/31/22
Summary of Benefits and Coverage (SBC) - Effective 1/1/21 - 12/31/21
Summary of Benefits and Coverage (SBC) - Effective 1/1/20 - 12/31/20

 

Legal Notices

•  
•  

• Vision Summary of Benefits

• VSP Vision Care Summary of Benefits - Effective 1/1/23 

• Cigna Vision Routine Vision Exam Summary of Benefits - Effective 1/1/22 - 12/31/22
• Cigna Vision Hardware Summary of Benefits - Effective 1/1/22 - 12/31/22
•  
• Cigna Vision Routine Vision Exam Summary of Benefits - Effective 1/1/21 - 12/31/21
• Cigna Vision Hardware Summary of Benefits - Effective 1/1/21 - 12/31/21
•  
• Cigna Vision Routine Vision Exam Summary of Benefits - Effective 1/1/20-12/31/20
• Cigna Vision Hardware Summary of Benefits - Effective 1/1/20-12/31/20
•  
•   

Medicare Prescription Drug Program Information

Navitus MedicareRx Evidence of Coverage - Effective 1/1/23
Navitus MedicareRx Summary of Benefits - Effective 1/1/23 
Navitus MedicareRx Annual Notice of Changes - Effective 1/1/23

Navitus MedicareRx Evidence of Coverage - Effective 1/1/22 - 12/31/22
Navitus MedicareRx Summary of Benefits - Effective 1/1/22 - 12/31/22
Navitus MedicareRx Annual Notice of Changes - Effective 1/1/22 - 12/31/22 

 

Life Insurance Certificates

Basic Life Insurance Certificate - Effective 1/1/23
Basic Life Insurance Certificate - Effective 1/1/22 - 12/31/22

Supplemental Life Insurance Certificate - Effective 1/1/23
Supplemental Life Insurance Certificate - Effective 1/1/22 - 12/31/22

Accidental Death and Dismemberment (AD&D) Certificate - Effective 1/1/23
Accidental Death and Dismemberment (AD&D) Certificate - Effective 1/1/22 - 12/31/22
Accidental Death and Dismemberment (AD&D) Certificate - Effective prior to 1/1/22
 
Retiree Life Insurance Certificate - Effective 1/1/22

Long Term Disability (LTD) Certificate - Effective 1/1/22
Long Term Disability (LTD) Certificate - Effective prior to 1/1/22

Life Insurance Certificate - Effective prior to 1/1/22 

 

HR/Payroll Publications

2022 ACA and the State Plan - presentation
Newly Eligible Employees - presentation

• Reduction in Force Employee Transition Document
•  
• 2023 Terminating Employee Benefit Coverage Calendar
• 2022 Terminating Employee Benefit Coverage Calendar
• 2021 Terminating Employee Benefit Coverage Calendar
•  

Workers' Compensation Management Bureau Publications

• Documents related to safety and return to work can be found on the WCMB website. 
•  

HIPAA Notice