Core Benefits
MEDICAL BENEFITS
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
Website: www.bcbsri.com
THE UNIFORM SUMMARY OF BENEFITS AND COVERAGE (SBC) IS A LEGALLY REQUIRED HEALTH PLAN DISCLOSURE DOCUMENT
Active Teachers HMTC no Rx SBC
BLUE CROSS SUMMARIES
Teachers HMCTC and Plan 750 Comparison
DENTAL BENEFITS
Provided by Delta Dental of RI
Delta Dental Enrollment Form
Billing – (401) 752-6200
Enrollment – (401) 752-6234
Customer Service – (401) 752-6100
Website: www.deltadentalri.com
DELTA DENTAL SUMMARY
PRESCRIPTION BENEFITS
Provided by CVS Caremark
Customer Service: 1-888-790-8070
Website: www.caremark.com
CVS CAREMARK SUMMARIES
VISION BENEFITS
Classic Blue and Healthmate Coast-to Coast 750 Plans
Provided by Blue Cross Blue Shield of RI
- One annual routine eye exam per the calendar year with co-payment under the 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
QUALIFYING EVENT
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
Open Enrollment occurs annually and allows you to alter your current health plan
- School Open Enrollment – September 1-30 for effective date of October 1, 2019
- Flexible Spending Account (FSA) Open Enrollment June 1-30, 2019 for effective date of July 1, 2019
Voluntary Benefits
DAVIS VISION
Davis Vision Reimbursement Form
FLEXIBLE SPENDING ACCOUNT (FSA)
Healthcare and Dependent Daycare – Flexible Spending Account – Administered by TASC
a. Enrollment Form
b. Advantages of an FSA
c. Dependent Care Qualifications
d. FlexSystem Eligible Expenses
e. MyCash Manager Guide
f. MyTASC Mobile Guide
TEACHERS – ALLSTATE
Short Term Disability, Long Term Disability, Critical Care, Cancer
Contact the Teacher’s Union 401-421-4014
FLU SHOTS
Employees and retirees can receive the flu vaccine at a local pharmacy by presenting their Blue Cross Blue Shield Card.
COORDINATION OF BENEFITS
Active Coordination of Benefits Form
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
