Employee Benefits 2006

Dallas, Texas

Employee Benefits 2006

Health & Wellness Calendar of Events
Employee Assistance Program
Wellness Program

2006 Publications

2006 Benefits & Enrollment Guide
Preliminary UHC 2006 Top 1000 Drug List (RX Formulary)
Benefacts

2006 Forms

Medical

Domestic Partnership Affidavit
Termination of Domestic Partnership

Life Insurance

Standard Life Insurance Conversion Request Form
Standard Life Insurance Beneficiary Designation/Change Form

Deferred Compensation

401(k) Retirement Savings Plan Beneficiary Designation Form
457 Deferred Compensation Plan Beneficiary Designation Form
457 PST Plan Beneficiary Designation Form

Beneficiary Designation

Employees' Retirement Fund (ERF) Beneficiary Designation Form
Active Employee Final Paycheck Beneficiary Designation Form

2006 PPO Plans - United Healthcare

80-20 PPO Plan - $300/$1000/$3000 Deductible
70-20 PPO Plan - $300/$1000/$3000 Deductible

2006 HMO Plan - Blue Cross

Blue Cross Summary Plan Description

2006 Voluntary Benefits -Marsh @ Work Solutions (see web site below)

Dental Plans - Safeguard (see web site below)

Vision Plan - Spectra (see web site below)

2006 Life Insurance Plans - Standard

Group Life Insurance Policy Amendment No. 6 to Policy 642563-A

2006 Flexible Spending Accounts - United Healthcare

United Healthcare Flexible Spending Account (EMSP and DCAP) Reimbursement Claim Form

2006 Legislative Notices

HIPAA Privacy Notice
HIPAA Plan Amendment

2006 Vendor Web Sites

Blue Cross Blue Shield - HMO
SEA - Employee Benefits Web Enrollment
Safeguard Dental Plans
Spectera Vision
Marsh@WorkSolutions-Voluntary Benefits

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