Human Resources - Retiree Benefits

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OPEN ENROLLMENT 2012 (En español)

UPDATE: New Health Benefit Center – City Hall 1DS
The Human Resources Health Benefits Service Center has relocated to the first floor of City Hall, room 1D-South. The service center is open Monday through Friday from 8 a.m. to 5 p.m.

• For customer service, call 888.752.9122.
• For details regarding your benefits, you can also refer to the City of Dallas 2011 Retiree Benefits & Enrollment Guide.

COVERAGE ALERT: New Mobile Apps

2011 Publications

2012 Retiree Benefits & Enrollment Guide (pdf)
2011 Retiree Benefits & Enrollment Guide (pdf)
Tobacco Cessation Information (pdf)
Documentation Required for all Insured Dependents (pdf)

Guía de Inscripción y Beneficios para los Jubilados-2010 (879 KB)
Life Insurance Certificate (for retirees that retired after October 1, 1974 and before
January 1, 2002)

UHC’s new Pharmacy Benefit Manager (PBM) – Prescription Solutions

UHC has changed the City’s Pharmacy Benefit Manager from Medco to Prescription Solutions. Members enrolled in the 70/30/3000 and the 75/25/HRA plans will receive new Medical ID cards during the week of September 20, 2010. On October 1, discard your Medical ID card that lists Medco as the PBM and replace with the new card that lists Prescription Solutions as our new vendor.

2011 Specialty Pharmacy Program Brochure
2011 Prescription Solutions Mail Order Form
2011 UHC Prescription Solutions PDL

Employees and their family members enrolled in a UnitedHealthcare medical plan can obtain Tier 1 Diabetes Therapy Medications without having to meet their deductible first! If you are currently taking a Tier 2 or Tier 3 Diabetes Therapy Medication, and you are interested in discussing lower-cost alternatives with your doctor, we have provided a list that you can share with your physician. If changing your medications is not an option for you, Tier 2 and Tier 3 medications on the PDL would still be covered, they would just be at a higher out of pocket cost to you.

2011 Summary of Prescription Drug List Changes
2011 Tier 1 Diabetes Therapy Medications

2011 HRA Plan Design

Benefit Tools and Resources
How to Use the HRA Plan

2011 Forms

Medical

Common-Law-Marriage Form (Dallas County Form; please visit your County Records
Building for this form)

Life Insurance

UnitedHealthcare Specialty Benefits Conversion Request Form
UnitedHealthcare Specialty Benefits Beneficiary Designation/Change Form (En Español)
United Healthcare Specialty Benefits Will & Trust Information

Deferred Compensation

401(k) Plan Enrollment Guide
457 Plan Enrollment Guide

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) Designee Form 
Dallas Police & Fire Pension (PFP) Designee Form

2010 PPO Plans - United Healthcare

75-25 PPO Plan – $1000/$2000 HRA Plan Summary of Benefits
70-30 PPO Plan - $3000 Deductible Plan Summary of Benefits

2011 Dental Plans

UHC Dental PPO Covered Services
UHC Dental HMO Covered Services

2011 Vision Plans

UHC Vision Plan

Life Insurance certificate (for retirees that retired after October 1, 1974 and before January 1, 2002)

2011 Legislative Notices

HIPAA Privacy Notice
HIPAA Plan Amendment

2011 Vendor Web Sites and Customer Service Numbers

Archives

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