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Your Benefits Page

 

Quick Links

 

Documents, Forms, Company Information Etc.

(All documents and forms are also available in Human Resources free of charge.

To request a CD or hard copy, please email or call 530.332.7344.)

 

 

 

Company

Contact Info

Documents & Forms

 

Keenan HealthCare (Medical)

 

 

Keenan Healthcare - Plan Administrator


To access Claim info and EOBs
https://keenan-mesa.javelinaweb.com/

Customer Service & Coverage questions:
1.877.365.6399

Eligibility & Cobra Question: 1.310.212.0363 ext 3332

Claims Questions:
1.310.212.0363 ext 3246

 

Plan Documents

Employee Medical Benefit Summary Plan Description 2011


Forms

FINDING
A
MEDICAL PROVIDER

Anthem Blue Cross PPO Prudent Buyer network

California: www.anthem.com/ca

Outside of California: www.bluecares.com

Company Contact Info Documents and Forms

Express Scripts
( Prescriptions)

1.888.605.1396

www.express-scripts.com


2013 Prime Formulary

2013 Prescription Coverage Summary

Prescription Drug Claim Form

Company Contact Info Documents and Forms

Delta Dental

1.800.765.6003

www.deltadentalins.com

Delta Dental EOC

Dental Benefits Summary

2012 Annual notice Delta Dental of California

Delta Claim Form

Company Contact Info Documents and Forms

VSP
(Vision)

1.800.877.7195

www.vsp.com

VSP Evidence of Coverage

VSP Summary of Benefits

VSP Out-of-Network Reimbursement Form

Company Contact Info Documents and Forms

Sun Life

Financial

 

(Life and AD&D)

www.sunlife.com/us
Account Rep: (949) 554-9948
Claims Dept: (800) 247-6875

 

Life and AD&D Benefit Summary

Sun Life Cert. Basic Life and AD&D

Company Contact Info Documents and Forms

 

Keenan

Flexible
Spending
Account

Section 125 Plan

FSA Account Questions:
800.653.3626 ext 3614

Flexible Spending:
Check your YTD account activity at
https://keenan-mesa.javelinaweb.com/


FSA Sec. 125 Plan Doc

FSA - FAQ

2013 Health Care Info

2013 Dependent care info

2013 Sample Expenses

REIMBURSEMENT FORMS

Health Care Expenses

Dependent Care Expenses

Fax form to 310.212.3381

Company Contact Info Documents and Forms

VALIC
(Retirement)

Chico office:
530.891.4960

Account Access &
Guided Portfolio Services:
www.valic.com

Fee Disclosure

Summary Plan Description

2012 SPD 401a

 

2012 SPD 403b

Forms Etc.

VALIC Meeting Schedule

403b Salary Reduction Agreement

VALIC Beneficiary Designation Form

Company Contact Info Documents and Forms

MHN,

Managed Health Network

Employee
Assistance Program

www.mhn.com.

Need Help?

Call MHN 24hrs 7days per week 1(800)535-4985

or

For more resources,information and to Watch the 15min Training Video Register at members.mhn.com

WELCOME BROCHURE

Company Contact Info Documents and Forms
Work Site Solutions
(Voluntary Benefit Programs)

www.combinedinsurance.com

Enrollment: 800.299.1377
Customer service for current policy owners: 800.544.9382

For More Questions

  • For questions concerning your retirement plan(s), please email or call Enloe's Human Resource Analyst at 530.332.7037.
  • For all other benefits questions, please email or call Enloe's Benefits Specialist at 530.332.7090

FREQUENTLY USED FORMS

1. Newly benefit eligible employees Please use ALL 3 forms

Benefits Enrollment form(Please Print on legal paper)

Coordination of Benefits Form

Medicare as a secondary payer questionaire

 

2. Midyear changes do to a qualify event (marriage, birth, divorce etc.) please fill out and return the following form to HR within 31 days of the date of the qualifying event

Benefits Change Form 2013 (please print on legal size paper)

3. Flexible Spending Account Reimbursement forms:

Health Care Expenses

Dependent Care Expenses

For more information please contact:
Ann Welch in Human Resoureces

    • ann.welch@enloe.org
    • (530) 332-7090

     

All forms and documents are also available on CD or hard copy in Human Resources at no charge.