Type: PDF – Size: 5.9 MB
Company Identifier: HighmarkHM
Coverage Period:
Aug 1, 2023 to July 31, 2024
Group Number:
650878
Member Services:
888.806.5094
Find a Provider:
Click to Find a Provider
Select “Employer or School”,
then OAP Network
(Open Access Plus, OA plus, Choice Fund OA Plus)
Medical Documents
Prescription Documents
Wellbeing Documents
Coverage Period:
Aug 1, 2023 to July 31, 2024
Group Number:
650878
Member Services:
888.806.5094
Find a Provider:
Click to Find a Provider
Vision Documents
Stay Connected Anywhere!
The myCigna app gives you a new and improved way to easily access your important health information. You must be a Cigna customer to use the secure myCigna mobile app. Features available are based on the coverage you have with Cigna.
HealthKit is integrated into myCigna in order to serve the ability to customize your Find Care and Telehealth experience.
ID Cards
Instantly view ID cards (front and back)
Easily print, email, or share from your mobile device
Find Care
Search for a doctor, dentist, pharmacy, or health care facility, from Cigna’s national network and compare quality-of-care ratings and costs
Claims
View and search recent and past claims
Account Balances
Access and view health fund balances
Pharmacy
View and refill your prescriptions right from your mobile device
Update billing and shipping preferences
Coverage
View plan coverage and authorizations
Review plan deductibles and maximums
Find what’s covered under your plan
Wellness
View goal activity and awards
Languages Supported
Spanish and English
What is a HSA?
Viewing Your Account Settings.
Coverage Period:
August 1st to July 31st
Contact:
800-859-2144
Monday-Friday
7:00 a.m. to 8:00 p.m. (Central Time)
Fax:
866-231-0214
eMail:
[email protected]
Website:
Further.com
An HSA is a personal savings account that can help you build a nest egg for future healthcare expenses. When you need healthcare in the future you can use the account to pay for qualified healthcare expenses, even once you have retired. You do not pay taxes on your contributions, earnings or withdrawals, if you use the account for qualified expenses. Any unused money in your account at the end of the year remains yours to use on eligible medical expenses in the future.
HSA Documents
Important Links
Get the App!
Further’s mobile app moves with you
Life is about living – not putting life on pause. The Further mobile app is in your pocket ready for the moment you need it.
Coverage Period:
August 1st to July 31st
The Flexible Spending Account Plan through Flores allows employee contributions up to $5,000 to an employee’s dependent care account and $1,500 to an employee’s medical spending account for each plan year, August through July.
FSA Documents
Coverage Period:
Aug 1, 2023 to July 31, 2024
Group Number:
650878
Member Services:
888.806.5094
Find a Provider:
Click to Find a Provider
Select “Employer or School”,
then Total Cigna DPPO
Dental Documents
Coverage Period:
Aug 1, 2023 to July 31, 2024
Policy Number:
678313
Customer Service:
800-523-2233
M-F: 8 a.m. to 8 p.m. ET
(Claims)
800-549-6514
Email:
[email protected]
Website:
TheHartford.com
All full-time employees are provided with a short-term disability (STD) and a long-term disability (LTD) policy through The Hartford. These policies are provided on a non-contributory basis, which means that Highmark Companies, LLC pays 100% of the cost for employees.
STD Documents
LTD Documents
Coverage Period:
Aug 1, 2023 to July 31, 2024
Policy Number:
678313
Customer Service:
800-523-2233
M-F: 8 a.m. to 8 p.m. ET
(Claims)
888-563-1124
(Beneficiary Assistance)
800-411-7239
Email:
[email protected]
Website:
TheHartford.com
We offer Basic Life and AD&D Insurance as a part of our basic package through The Hartford and we provide this coverage at no cost to you.
Basic Life Documents
Voluntary Life Documents
Benefit Highlights – Voluntary Life
Voluntary Life Certificate
Dependent Voluntary Life Certificate
Beneficiary Assistance
Funeral Concierge Services
EstateGuidance Will Services
Notice of Conversion and Portability Rights
Life EOI Process Guide
Life EOI Form
Life EOI Form for California
Life EOI Form for Virginia
You may contribute up to 100% of your eligible compensation up to $20,500 per year (subject to IRS limits). Highmark Companies, LLC will match 100% of your contributions up to 3% of eligible compensation, plus 50% on the next 2%. If you contribute 5% of your eligible compensation, you will receive the maximum match of 4% of eligible compensation.
401(k) Enrollment Kit
401(k) Forms
Initial Enrollment Form – For new enrollees to sign up for the 401(k) plan.
Beneficiary Designation Form – For new enrollees or existing participants to designate or change beneficiaries.
Deferral Election Change Form
Rollover Contribution Form – For when a participant chooses to roll money INTO the Plan.
Loan Application Request Form – To request a loan from the Plan.
Special Tax Notice for 401(k) Plans – Must be reviewed when requesting distributions from the Plan.
Death Benefit Request Form – Used by the beneficiary of a deceased Participant.
Death Benefit Request Notice
Distribution Request Form – For when a participant is requesting distribution (taxable or rollover to another plan).
Distribution Request Notice
Financial Hardship and Withdrawal Request Form – For when a participant requests a withdrawal from the Plan due to financial hardship.
Financial Hardship Request Notice
ABILITY ASSIST®
Coverage Period:
Aug 1, 2023 to July 31, 2024
Company Name: Abili
Company ID: HLF902
Counseling Service:
800-964-3577
Website:
www.guidanceresources.com
Highmark Companies, LLC WRAP SPD (Through 7-31-2023)
HIPAA Notice
Women’s Health and Cancer Rights Act Enrollment Notice
Newborns’ and Mothers’ Health Protection Act Disclosure
Patient Protection Notice
HIPAA Special Enrollment Notice
Premium Assistance Under Medicaid and CHIP Notice
Genetic Information Nondiscrimination Act (GINA) Disclosures
USERRA Notice
Notice of COBRA Continuation Coverage Rights
Medicare Part D Coverage Notice
Health Insurance Marketplace Notice
Common Health Insurance Terms
When you’re choosing a health plan that’s offered by your employer, you’ll run across terms and phrases that may be unfamiliar to you. Understanding these common health insurance terms can help as you decide on coverage for the coming year.
Network: A clinic, hospital, doctor, lab, health care practitioner, or pharmacy.
Insurer or carrier: The insurance company providing coverage to the policy holder.
Policyholder: The individual or business (“group”) that has entered a contractual relationship with the insurance company.
Insured: The person with the health insurance coverage. For individual health insurance, you may be both the policy holder and the insured.
Premium: The amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, number of dependents and tobacco consumption. Policy holders pay these rates annually or in smaller payments over the course of the year, and the amount may change over time. When insurance premiums are not paid, the policy is typically considered void, and companies will not honor claims against it. Self-employed persons may deduct the cost of their individual health insurance premiums from their taxes.
Copayment (Copays): A fixed amount you pay for a covered health care service, usually when you get the service. The amount can vary by the type of covered health care service.
Preauthorization: A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment (DME) is medically necessary. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency.
Preventive Care: Medical tests and checkups, immunizations, and counseling services used to prevent chronic illness from occurring.
Diagnostic Care: Care you receive to help diagnose symptoms or risk factors you already have.
Primary Care Provider (PCP): Routine health care, including screenings, check-ups and patient counseling to prevent or discover illness, disease or other health problems.
Referral: A written order from your primary care provider for you to see a specialist or get certain health care services.
Specialist: A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has special training in a specific area of health care.
Deductible: The amount you owe for health care services each year before the insurance company begins to pay. For example, if your annual deductible is $1,000, your plan won’t pay anything until you’ve met your $1,000 deductible for covered health care services that are subject to the deductible. The deductible may not apply to all services, such as preventive care services.
Deductibles are useful for keeping the cost of insurance low. The amount varies by plan, with lower deductibles generally associated with higher premiums. They are standard on most types of health coverage.
Coinsurance: Your share of the costs of a covered health care service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.
Out-of-Pocket Maximum: The most you will be required to pay for your health care during a year, excluding the monthly premium. It protects you from very high medical expenses. After you reach the annual out-of-pocket maximum, your health insurance or plan begins to pay 100 percent of the allowed amount for covered health care services or items for the rest of the year. Copays, deductibles, and coinsurance count towards the out-of-pocket maximum.
Formulary: A list of prescription drugs covered by the plan. Also called a drug list.
In-Network: A group of doctors, clinics, hospitals, and other healthcare providers that have an agreement with your medical plan provider. You pay a negotiated rate for services when you use in-network providers.
Out-of-Network: Care received from a doctor, hospital or other provider that is not part of the plan agreement. You’ll pay more when you use out-of-network providers since they don’t have a negotiated rate with your plan provider. You may also be billed the difference between what the out-of-network provider charges for services and what the plan provider pays for those services.
High Deductible Health Plan (HDHP): This is a type of medical plan that requires the member to reach a deductible prior to having services covered by coinsurance. All expenses paid by the member count toward the deductible and out-of-pocket maximum.
Prescription Drug List (PDL): Every plan with a pharmacy benefit contains a Prescription Drug List (PDL), also known as a formulary. The PDL lists the plan-approved drugs that your insurance will help pay for as well as how cost sharing works in each tier of drugs.
Prior Authorization: A requirement from your health plan that some medications have additional coverage requirements which require approval from the health plan before you receive the medication.
Guaranteed Issue: The amount of coverage that you can receive without having to answer health questions (Evidence of Insurability). The guaranteed issue applies to the voluntary life plan.
Evidence of Insurability: Evidence of Insurability (EOI) is an application with medical questions that you complete in order to be considered for certain types of insurance coverage. Evidence of Insurability applies to the voluntary life and buy-up long-term disability plans.
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DISCLAIMER
Every reasonable effort has been made for the information provided to be accurate. It is intended to provide an overview of the coverage’s offered. It is in no way a guarantee or offer of coverage. Each carrier has the ability to underwrite based on its contract. Each carrier’s contract, underwriting, and policies will supersede the information on this page. Please be aware that each carrier may have exclusions or limitations and you must consult your summary plan description and/or policies for details.