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Information & Forms for Participants in City of Chico Benefits

 

General City of Chico Benefits Information

 

General Information

• 2012 Summary of Medical Benefits
• 2012 Benefits Rates
• Preventive Services Covered under the Affordable Care Act
• Benefits Application & Change Form

 

Health Insurance Plan Summaries              

• Anthem EPO Benefits Summary
• 2011 Anthem EPO Evidence of Coverage
• Anthem HDHP Benefit Summary
• 2011 Anthem HDHP Evidence of Coverage
• Anthem PPO 80-20 Benefit Summary
• 2011 Anthem PPO 80 Evidence of Coverage
• Anthem PPO 90-10 Benefit Summary
• 2011 Anthem PPO 90 Evidence of Coverage

 

Anthem Blue Cross Information                  

• Anthem Blue Cross Online Resources
• Anthem Blue Cross Condition Care
• Anthem Blue Cross 24/7 Nurse Line
• Anthem Blue Cross Special Offers 
• Anthem Blue Cross Drug Formulary
• Anthem Specialty Pharmacy (HDHP)

 

Anthem Blue Cross PPO (Prudent Buyer) Provider Listings

• How to Find a Provider Instructions
• Anthem Blue Cross Provider Listing - Butte County
• Anthem Blue Cross Provider Listing - Colusa County
• Anthem Blue Cross Provider Listing - Glenn County
• Anthem Blue Cross Provider Listing - Sutter County
• Anthem Blue Cross Provider Listing - Tehema County
• Anthem Blue Cross Provider Listing - Yuba County
• Anthem Blue Cross Provider Listing - Behavioral Health
• Anthem Blue Cross Provider Listing - Chiropractic
• Anthem Blue Cross Provider Listing - Acupuncture

 

Medco Pharmacy Information

• Medco Frequently Asked Questions
• Medco Pharmacy Listing – Butte County
• Medco Formulary Guide Nov 2010
• Medco Mail Order Form
• Medco EPO Plan Summary
• Medco PPO Plan Summary

 

Sterling HSA

• Sterling HSA Individual Application
• Sterling HSA Salary Redirection Form

 

Delta Dental

• Delta Summary of Benefits
• Delta Dental Dentist Directory
• Delta Dental Informational Flyers
• Delta Claim Form

 

SafeGuard Vision

• SafeGuard Schedule of Benefits
• Safeguard Provider Listing
• SafeGuard Informational Flyers
• Vision Claim Form

 

Employee Assistance Program

• MNH Website
• MHN Informational Flyer
• MHN Legal Services Flyer
• MHN Financial Services Flyer
• MHN Evidence of Coverage

 

CBA Section 125

• CBA 2012 Section 125 Enrollment Packet
• CBA Welcome Packet
• Section 125 Summary Plan Description - July 2011
• Section 125 Reimbursement Form
• Section 125 Dependent Care Reimbursement
• Section 125 Direct Deposit Enrollment

 

CalPERS

• CalPERS Beneficiary Designation (BSD-241)
• Planning Your Service Retirement (Pub 1)
• Service Retirement Application (Pub 43)
• Your Benefits - Local Misc (Pub 8)
• Your Benefits - Local Safety (Pub 9)
• Service Credit Purchase Options (Pub 12)
• Power of Attorney (Pub 30)
• CalPERS Pension Worksheet

 

Hartford Deferred Compensation

• Hartford Change Form
• Hartford Loan Application

 

Nationwide Deferred Compensation

• Nationwide Beneficiary Change Form
• Nationwide Loan Program

 

Unum Life Insurance (City Paid)

• Unum Life Insurance Certificate of Coverage

• Unum Life Insurance Beneficiary Designation

 

Unum Supplemental Life Insurance

• Unum Life Insurance Coverage Summary
• Unum Supplemental Life Application
• Unum Evidence of Insurability
• Unum Supplemental Life Beneficiary Designation