Open Enrollment - FY23

SHPG Open Enrollment FY23

Benefit Contact Information

The Annual Open Enrollment period is the ONLY time that you may change health insurance plans or make changes to your existing plans (including canceling) without a qualifying event. (Changes/cancellation requests must be made within 30 days of a qualifying event)

Health Insurance

The only time you may enroll (or cancel) benefits is at Open Enrollment unless you have a Qualifying Event.

• Pre/Post Tax Deduction Notice

Qualified changes in status include: marriage, divorce, legal separation, birth or adoption of a child, change in child’s dependent status, death of spouse, child or other qualified dependent, change in residence due to an employment transfer for you or your spouse, commencement or termination of adoption proceedings, or change in spouse’s benefits or employment status.  Please provide proof of change within 30 days of Qualifying Event.

• Rate Letter 
• Blue Cross Enrollment Form

• If adding spouse – copy of Marriage Certificate
• If adding birth child – copy of Birth Certificate(s)
• If adding an adopted child or legal guardianship of child  – copy of court document showing custody
• If adding a divorced spouse – copy of Divorce Decree showing requirement to cover an ex-spouse

• HMO & PPO Plan Design Comparison
• Network Blue New England Summary  
• Network Blue New England Summary of Benefits and Coverage
• Blue Care Elect Summary (PPO)
• Blue Care Elect Summary of Benefits and Coverage
• Telehealth Member Brochure 
• Using Find A Doctor
• Understanding Your Deductible
• Health Insurance Opt Out Form
• Step In Program 

• Diabetes Care Value Program 

Dental Insurance

• Atlus Dental Summary of Benefits and Rates
• Atlus Dental Maximum Carryover Benefit
• Atlus Dental Enrollment Form

Deferred Compensations Plan

• Great West (Smart Plan) Contact info
• Great West Appointment Scheduler
• Great West Plan Information (457 Deferred Compensation Plan)  
• Nationwide Contact Info and Appointment Scheduler
• Nationwide Plan Information (457 Deferred Compensation Plan) 
• Nationwide Plan Highlights

Optional Insurance

• Boston Mutual - Accident Plan
• Cololnial Life Open Enrollment Notice
• Colonial Life Options 
• Colonial Life - Appointment Scheduler
• Aflac
  • Aflac Insurance Options
  • Aflac - Appointment Scheduler
  • Aflac Insurance Products 

Other Benefits Offered

• Employee Assistance Program (Perspectives) 
• United Way
• CanaRX
• CanaRX Enrollment Package 
• CanaRx Formulary

Important Disclosure Information

• COBRA Continuation Coverage
• Women's Health and Cancer Rights Act
• HIPAA Notice of Privacy Practices
• HIPAA Special Enrollment Rights
• Patient Protection Disclosure
• Premium Assistance (CHIP)
• FMLA General Guidelines

• The Uniformed Services Employment and Reemployment Rights Act (USERRA)

• MCAD Pregnant Workers Fairness Act