• For additional Horizon Health EAP information call 800-955-6422, or visit www.horizoncarelink.com,
  [ login: Waco, TX / password: eap]

HIPAA (Health Insurance Portability and Accountability Act)

• Notice of Individual Privacy Rights
• Notice to Enrollees in a Self-Funded Non-Federal Government Group Health Plan

RATES (PREMIUMS)

Group Medical, Voluntary Dental and Voluntary Vision Rates
• Effective 10-01-09 to 09-30-10

• To contact Blue Cross Blue Shield of Texas call 800-521-2227 or visit www.bcbstx.com
• Health Plan – Certificate of Coverage
• Qualifying Event

• Rx Programs
• Specialty Rx Program

• Summary of Benefits
• For more information, visit www.prudential.com.

• Summary of Benefits
• LTD Detailed Plan Booklet
• Texas Guaranty Association Notice

SHORT TERM DISABILITY

• Summary of Benefits
• STD Detailed Plan Booklet
• Texas Guaranty Association Notice

• For more information about TMRS and the plan provisions that the City has adopted call 1-800-924-8677 or visit http://www.tmrs.com.

• For Metlife information call 1-800-521-7503 or visit http://www.travelersla.com.
• For ICMA information call 1-800-669-7400 or visit http://www.icmarc.org.
• For Nationwide information call 1-877-677-3678 or visit http://www.nrsforu.com.

• For additional CIGNA Dental information call 800-244-6224 or visit www.cigna.com.
• CIGNA Summary of Benefits
• For additional QCD Dental information call 800-229-0304 or visit www.qcdofamerica.com.

CAFETERIA PLAN

• PayFlex Systems USA, Inc., administers the City's cafeteria plan:
  P.O. Box 3039
  Omaha, NE 68103-3039
  800-284-4885
  Fax: 402-231-4310
• Reimbursement Claim Form
• Reimbursement Claim Filing Instructions
• Summary Plan Document

VISION PLAN

• For additional United Healthcare Vision information call 800-638-3120 or visit www.myuhcspecialtybenefits.com