2010 Benefits Open Enrollment
Forms & Documents
- Medical Plan Document (754k)
- Medical & Dental Enrollment Form (279k)
- Health Benefits Pre-Tax Form (38k)
- Domestic Partner Application & Policy (195k)
- Qualified Dependent Declaration Form (82k)
- Declaration of Health Coverage Form (61k)
- CIGNA Medical Claim Form (40k)
- Medical Appeals Process (60k)
- Notice of Privacy Practices (140k)
Contact
- Jerry Fry
(802) 828-3455
jerry.fry@state.vt.us
- Anne Carver
(802) 828-0648
anne.carver@state.vt.us
- Department of Human Resources
144 State Street
Montpelier, VT 05620-1701
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It’s that time of year again! Open Enrollment runs November 1 to November 30 for the 2010 benefit plan year. This is your annual opportunity to change the health plan option you are enrolled in, or add dependents. If you wish to add dependents or make a change in your health plans, now is the time to do so. If you take no action, your enrollment in these plans will continue as is. You only need to act if you wish to make changes. All applications and forms needed to make changes can be found in the Forms & Documents box to the right.
Benefit Fairs Schedule
11/09/09 Waterbury The Summit, Osgood Building
11/10/09 Rutland Asa Bloomer Building, Merchant’s Row
11/12/09 Burlington 108 Cherry Street, Conference Room 2B
11/13/09 Montpelier The Pavilion, 109 State Street
The fairs run from 9:00 until 3:00. Representatives from the Employee Benefits Unit will be there to answer your questions. In addition, representatives from Cigna Healthcare, Express Scripts, Inc., and Great West will be at most locations as well.
New Premium Rates
Effective January 1, 2010, it is expected that premium rates will increase by 9.8% for all state employee health plans effective with the January 14, 2010 paychecks. Proposed rates for 2010 are listed below.
Premium Holiday
Due to a surplus in the plan fund, we anticipate that there will be a premium holiday, but this year will work a little different from past years. For the check date of 12/18/09, no medical plan premium will be deducted. For the check date of 12/31/2009, only 35% of your normal medical plan premium will be deducted.
Prescription Drug Plan
Beginning 2010, the maximum annual member out-of-pocket (or cost share) will increase to $750, including the $25 individual / $75 family deductible. Please note - Non-preferred brand drugs (40% co-pay plus ancillary fee) do not count towards the yearly maximum out-of-pocket. A copy of the 2010 Drug Formulary can be found below.
Flexible Spending Account Plans
We are thrilled to be able to offer the myFBMC™ Visa Debit Card this year as a new option for employees who enroll in a Medical Flexible Spending Account (FSA). Use of the debit card is not required. This plan enhancement is a new option to all medical FSA plan enrollees and minimizes the hassle of completing claim forms for reimbursement. Please note – current participants of in the FSA plan must re-enroll for 2010. Full information about enrolling in the FSA plan was sent in the enrollment packet you should have received by mail.
Life Insurance
There will be an increase to the Life and Accidental Death and Dismemberment premiums of 3.8%.
Declaration of Health Coverage Forms
If you are eligible to enroll in one of the state employee health plans but have other health insurance coverage, you are required to submit a Declaration of Health Insurance Coverage Form. This form, which is mandated by law, can be found in the Forms & Documents box to the right.
New Colonoscopy Benefit for 2010
Effective January 1, 2010 screening flexible sigmoidoscopy or screening colonoscopies are covered as a first dollar benefit, with a members paying a maximum of $100 co-payment; no deductible applies. This does not apply to the SelectCare plan, as there is no out-of-pocket expense for outpatient procedures, but applies to TotalChoice, HealthGuard, and SafetyNet members; coverage is 100% after the $100 maximum cost share.