Provided by Blue Cross Blue Shield of Rhode Island
Blue Cross Blue Shield Enrollment Application
Local – (401) 459-5000
Out of state residents – 1-800-369-2227
THE UNIFORM SUMMARY OF BENEFITS AND COVERAGE (SBC) IS A LEGALLY REQUIRED HEALTH PLAN DISCLOSURE DOCUMENT
BLUE CROSS SUMMARY
Provided by Delta Dental of RI
DELTA DENTAL SUMMARY
Provided by CVS Caremark
Customer Service: 1-888-790-8070
CVS CAREMARK SUMMARY
Provided by Blue Cross Blue Shield of RI
- One annual routine eye exam per the calendar year with co-payment under a medical policy
- Prescription glasses (lenses and or frames) or contact lenses are covered up to a maximum of $100 per -calendar year. Members pay the full charge whether using a participating or non-participating provider and files claim to BCBSRI for reimbursement
A life event that allows you to make changes to your current health plan
- Qualifying Events include: Marriage/Birth/Adoption/Loss of coverage
- Documentation: Marriage License/Birth Certificate/Adoption papers/ HIPAA letter
- All changes must be submitted within 30 days of the qualifying event with the proper documentation.
Open Enrollment occurs annually and allows you to alter your current health plan
- School Open Enrollment – September 1-30 for an effective date of October 1, 2019
- Flexible Spending Account (FSA) Open Enrollment June 1-30, 2019 for an effective date of July 1, 2019
FLEXIBLE SPENDING ACCOUNT (FSA)
Healthcare and Dependent Daycare – Flexible Spending Account – Administered by TASC
Employees and retirees can receive the flu vaccine at a local pharmacy by presenting their Blue Cross Blue Shield Card.
COORDINATION OF BENEFITS
Applies to spouses/qualified ex-spouses of active employees who have access to health coverage through his/her employer. Working spouses/ex-spouses must enroll in an individual plan with his/her employer. You as the employee will be reimbursed in your bi-weekly paycheck the cost that your spouse gets deducted out of his/her paycheck.
- Your spouse/ex-spouse remains enrolled in full coverage with the City.
- Your spouse/ex-spouse is enrolled in his/her employer’s plan as primary and the City’s plan as secondary.
- You are reimbursed for the cost of the plan (co-share) that your spouse/ex-spouse pays out of his/her paycheck.
- Whatever the spouse’s/ex-spouse’s employer ‘s plan does not cover, the City’s plan covers.
- If the only plan available to a working spouse is an HSA, the spouse does not need to enroll (proof/documentation required)
- Proof and cost of coverage required – see FAQ for details