2021 Open Enrollment Materials
Below is the complete list of 2021 Open Enrollment materials.
Active Clergy/Active TAC Fiscal Office Lay Employees
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Document |
What it's for... |
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1 |
2021 group health highlights for active clergy and TAC Fiscal Office lay employees |
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2 |
Active clergy and TAC Fiscal Office lay employee open enrollment instructions |
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3 |
What's changing in 2021 for active clergy and TAC Fiscal Office lay employees |
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4 |
Submit enrollment form only if making changes in your plan elections or dependent coverages in 2021 |
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5
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2021 Boon-Chapman Annual Additional Insurance Form (required each year for enrolled dependents) |
Must be submitted by January 1 each year or dependent benefits are limited to $1,000 until completed form is received. |
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6 |
Comparison of plans, premiums and enrollment instructions |
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7 |
Overview of plan details |
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8 |
Overview of plan details |
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9 |
Overview of plan details |
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10 |
RxBenefits~Express Scripts Introduction |
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11 |
RxBenefits~Express Scripts Prescription Benefit Coverage Summary |
Overview of prescription drug plan |
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12 |
Guidelines for treatment at the ER or Urgent Care Center |
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13 |
High Deductible Health Plans (HDHP) and Health Savings Accounts (HSA) |
Understanding HDHP plans and setting up a tax-advantaged HSA |
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14 |
Overview of plan details |
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Government Required Notices |
Required legal notices |
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15 |
Your Standard PPO Plan benefits in health care reform standard format |
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16 |
2021 High Deductible Health Plan Summary of Benefits and Coverage |
Your HDHP benefits in health care reform standard format |
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17 |
Protection of your personal health information
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18 |
Assistance to help pay for your employer group health plan coverage if you or your children are eligible for Medicaid or CHIP |
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19 |
Mother and new baby benefit information |
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20 |
Women’s health and cancer benefit information |
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21 |
Your prescription drug benefit compared to Medicare Part D |
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22 |
Wellness program information |
Under 65 Early Retirees / Under 65 Spouses of Medicare Primary Participants / Under 65 Surviving Spouses
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Document |
What it's for... |
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1
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2021 group health highlights for under age 65 early retirees, spouses and other dependents of Medicare Primary participants and surviving spouses |
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2 |
2021 enrollment information and instructions for under age 65 early retirees, spouses and other dependents of Medicare Primary participants and surviving spouses |
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3 |
What's changing in 2021 for under age 65 early retirees, spouses and other dependents of Medicare Primary participants and surviving spouses |
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4 |
Enrollment form for under age 65 early retirees, spouses and other dependents of Medicare Primary participants and surviving spouses who want to change plan elections |
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5 |
Must be submitted by January 1 each year or dependent benefits are limited to $1,000 until completed form is received |
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All documents numbered 6 – 22 above pertain to under age 65 early retirees, spouses and other dependents of Medicare Primary participants and surviving spouses |
Additional 2021 OE documents |
Benefits Disclaimer About Your Benefits