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Healthcare - Assistance Plan (HCAP) Documents

HealthCare Assistance Plan (HCAP) Documents

full plan Information

2017 HCAP Plan Document
2016 HCAP Plan Document

SUMMARY PLAN INFORMATION

Enrollment Applications

2017 Employee Healthcare Enrollment Application | LEGACY
2017 Employee Healthcare Enrollment Application | OPTION (DEFAULT TO STANDARD PLAN) | OPTION (DEFAULT TO CURRENT PLAN)
2017 Employee Healthcare Enrollment Application | STANDARD

2016 Employee Healthcare Enrollment Application | LEGACY
2016 Employee Healthcare Enrollment Application | OPTION (DEFAULT TO STANDARD PLAN) | OPTION (DEFAULT TO CURRENT PLAN)
2016 Employee Healthcare Enrollment Application | STANDARD

Decline Coverage Form
Disability Certification Forms

 

Reimbursement & Change Forms

Employee Benefits Change Request Form
Employee Benefits Termination Request Form

 

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Click here to search the Participating Provider Directory.
 

video tutorialS

 How to Add a Dependent Spouse to Coverage

 How to Add a Newborn

 How to Add a Newly Married Spouse

 How to Add an Adult Child to the Plan

 How to Approve a New Enrollment or Life Event

 How to Change a Full Time Employee to Part Time

 How to Change a Part Time Employee to Full Time

 How to Enter Coordination of Benefits information

 How to Put a Benefit Eligible Part Time Employee on Coverage

 How to Rehire an Employee with an Existing Account

 How to Remove a 26 year old from Coverage

 How to Remove a Dependent Spouse from Coverage

 How to Terminate an Employee

 How to Verify who has Coverage

 

 Healthcare Open Enrollment for 2015 
Download the Presentation (PDF 303 KB)

 Healthcare Transition for PPO and Member Services in 2015 
Download the Presentation (PDF 2.7 MB)