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Health Benefits for Employees

Medical, dental and vision plan information.

• 2010 Active Benefits Enrollment Guide (pdf)
• Benefits Enrollment Guide for Active Employees (pdf)
• How to Contact Your Benefits Plan Directly (pdf)
• Life Events/Change in Status Overview (pdf)
• Benefits Change Form - Active Employees (pdf)

Medical Plans

• AETNA
• CareFirst
• Kaiser Permanente
• NCAS
• United Healthcare

Dental Plans

• Delta Dental
• NCAS Dental

VIsion Plans

• NCAS Vision Care
• Vision Service Plan (VSP) (pdf)

Life Insurance and Accidental Death and Dismemberment (AD&D) Insurance

HCPSS pays for core life and AD&D insurance for all eligible employees. Employees receive a benefit equal to one times their annual earnings (rounded up to the nearest $1,000), to a minimum of $10,000, up to a maximum of $250,000. AD&D provides financial protection for you and your family against expenses associated with accidental death or injury. A reduced benefit is payable should you become dismembered as a result of an accident.

The value of basic life insurance coverage in excess of $50,000 is considered imputable taxable income which is reported on your W-2 form at the end of the year.

• Beneficiary Designation Form (pdf)

Long-term Disability
All files are in PDF format.

• Long Term Disability Summary
• Long Term Disability Claim Form
• Medical History Statement

Flexible Spending Accounts 2009
Effective Oct. 1, 2008, HFS Benefits will administer HCPSS's flexible spending program -- medical and dependent care. Please submit all claims after Oct. 1, 2008, to HFS Benefits using the Request for Reimbursement Form found below. All files are in PDF format.

• Request for Reimbursement Form
• Enrollment Guide
• List of Eligible Medical Expenses
• Request for Duplicate/Additional MBI Card
• Direct Deposit Authorization
• Debit Card Substantiation Form