Payroll & Benefit Docs

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Ċ 2014-15 COST SHARING AMOUNTS.pdf
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2014-15 80/20 Benefit Cost Sharing  263k v. 1 Jun 25, 2014, 1:54 PM Ann Martin
 Dental and Vision Insurance Documents
Ċ 2014.7.1 Dental II.pdf
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Benefits-At-A-Glance - Dental II  172k v. 2 Jun 23, 2014, 2:14 PM Ann Martin
Ċ 2014.7.1 Dental I.pdf
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Benefits-At-A-Glance - Dental I   172k v. 2 Jun 23, 2014, 2:14 PM Ann Martin
Ċ 2014.7.1 Vision BAAG.pdf
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Benefits-At-A-Glance - Vision  119k v. 2 Jun 23, 2014, 2:14 PM Ann Martin
 Health Insurance Documents
Ċ 2013.11.1 PPO 4 SBC.pdf
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Summary of Benefits & Coverage PPO 4  454k v. 2 Oct 29, 2013, 8:11 AM Ann Martin
Ċ 2013-14 MHP Exemption Notice.pdf
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2013-14 Mental Health Parity Exemption Notice  114k v. 2 Jun 11, 2013, 7:43 AM Ann Martin
Ċ 2013.9.1 HSA SBC.pdf
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Summary of Benefits & Coverage HSA  454k v. 2 Oct 29, 2013, 8:11 AM Ann Martin
Ċ 2013.9.1 PPO 12 SBC.pdf
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Summary of Benefits & Coverage PPO 12  454k v. 2 Oct 29, 2013, 8:11 AM Ann Martin
Ċ 2013.9.1 PPO 2 SBC.pdf
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Summary of Benefits & Coverage PPO 2  456k v. 2 Oct 29, 2013, 8:11 AM Ann Martin
Ċ 2014.7.1 BAAG CB12 ECM.pdf
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Benefits-At-A-Glance PPO XII  371k v. 2 Jun 23, 2014, 2:12 PM Ann Martin
Ċ 2014.7.1 BAAG CB2 ECM.pdf
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Benefits-At-A-Glance - PPO II  372k v. 2 Jun 23, 2014, 2:12 PM Ann Martin
Ċ 2014.7.1 BAAG CB4 ECM 0004.pdf
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Benefits-At-A-Glance - PPO IV  371k v. 2 Jun 25, 2014, 1:41 PM Ann Martin
Ċ 2014.7.1 BAAG SB HSA.pdf
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Benefits-At-A-Glance - HSA  371k v. 2 Jun 23, 2014, 2:12 PM Ann Martin
Ċ Contact Information for Employees 3.29.12.pdf
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Brown & Brown (PEBS) Employee Assistance   41k v. 3 Mar 29, 2012, 6:51 AM Ann Martin
Ċ Individual Insurance Flyer.pdf
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Assistance With Individual Insurance Coverage for Those No Longer Eligible for APS Health Plans  73k v. 2 Nov 4, 2013, 2:18 PM Ann Martin
Ċ Marketplace Cover Letter.pdf
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The Marketplace Cover Letter  106k v. 2 Oct 1, 2013, 12:24 PM Ann Martin
Ċ Marketplace Notice.pdf
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The Marketplace Notification  93k v. 2 Oct 1, 2013, 12:24 PM Ann Martin
 HSA Information
Ċ 2012.11 Qualified Medical Expense Examples.pdf
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HSA Qualified Medical Expense Examples  221k v. 2 Nov 4, 2013, 2:18 PM Ann Martin
Ċ 2013.10 Five Great Reasons.pdf
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HSA Five Great Reasons  140k v. 2 Oct 29, 2013, 8:21 AM Ann Martin
Ċ 2013.8 FAQs.pdf
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HSA Frequently Asked Questions  147k v. 2 Oct 29, 2013, 8:21 AM Ann Martin
Ċ 2013.8 HSA Member Guide.pdf
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HSA Membership Guide  1458k v. 2 Oct 29, 2013, 8:21 AM Ann Martin
Ċ 2013.8 HSA Plan Examples.pdf
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HSA Plan Examples  136k v. 2 Oct 29, 2013, 8:21 AM Ann Martin
Ċ 2013.8 Verifying Your Identity.pdf
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HSA Verifying Your Identity  114k v. 2 Nov 4, 2013, 2:18 PM Ann Martin
Ċ 2014 & 2015 HSA Seed Money.pdf
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HSA Alpena Public Schools Seed Money  179k v. 2 Oct 29, 2013, 8:22 AM Ann Martin
Ċ Employee_HSA_Payroll_Deduction_Form_2013.pdf
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HSA Payroll Deduction Form  146k v. 2 Oct 29, 2013, 8:22 AM Ann Martin
 Life and LTD Insurance Documents
Ċ Employee Assistance Program.pdf
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Employee Assistance Program - Life  2594k v. 2 Nov 19, 2013, 12:38 PM Ann Martin
Ċ Long Term Disability - Admin & Admin Support - 8.1.2013.pdf
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LTD - Admin, Admin Support  143k v. 2 Nov 19, 2013, 12:34 PM Ann Martin
Ċ Long Term Disability - Teachers - 8.1.2013.pdf
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LTD - Teachers  142k v. 2 Nov 19, 2013, 12:34 PM Ann Martin
Ċ NIS Beneficiary Form.pdf
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Beneficiary Form - Life, AD&D & LTD  132k v. 2 Nov 19, 2013, 12:38 PM Ann Martin
Ċ Term Life - Admin & Admin Support - 8.1.2013.pdf
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Life & AD&D - Admin, Admin Support  128k v. 2 Nov 19, 2013, 12:34 PM Ann Martin
Ċ Term Life - Cafe & Custodial - 8.1.2013.pdf
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Life & AD&D - Custodial, Cafe  114k v. 2 Nov 19, 2013, 12:35 PM Ann Martin
Ċ Term Life - Drivers - 8.1.2013.pdf
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Life & AD&D - Drivers  114k v. 2 Nov 19, 2013, 12:35 PM Ann Martin
Ċ Term Life - Secretaries - 8.1.2013.pdf
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Life & AD&D - Secretaries  114k v. 2 Nov 19, 2013, 12:35 PM Ann Martin
Ċ Term Life - Teachers - 8.1.2013.pdf
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Life & AD&D - Teachers  114k v. 2 Nov 19, 2013, 12:35 PM Ann Martin
 Open Enrollment Documents
Ċ 2013-14 Cumulative Mandatory Notices.pdf
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Open Enrollment and Other Mandatory Notifications  480k v. 8 Oct 2, 2013, 6:40 AM Ann Martin
Ċ Enrollment and Change Form 4-1-14.pdf
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Medical Insurance Enrollment and/or Change Form  95k v. 3 Apr 4, 2014, 7:24 AM Leslie Reynolds
 Payroll Documents
Ċ DirectDepositPolicyandForms[1].pdf
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Direct Deposit Form   35k v. 7 Nov 5, 2013, 12:46 PM Nancy Wedge
Ĉ IA Timesheet 11-1-13.xls
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Instructional Assistant Timesheet  33k v. 2 Dec 12, 2013, 7:50 AM Kevin Mulka
Ĉ SecretaryTimeSheet8-2010.xls
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Secretary Time Sheet  22k v. 4 Aug 13, 2012, 11:40 AM Ann Martin
 Prescription Plan Documents
Ċ 2013.07 Custom-Formulary Listing.pdf
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Custom-Formulary Rx Listing  1944k v. 2 Oct 2, 2013, 6:53 AM Ann Martin
Ċ 2013-14 Creditable Coverage Disclosure 9.30.13.pdf
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Annual Notice of Rx Creditable Coverage   280k v. 2 Oct 2, 2013, 6:51 AM Ann Martin
Ċ 2014.7.1 BAAG $10$40$80-RXCM 0000-0015.pdf
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Benefits-At-A-Glance PPO Rx  317k v. 3 Jun 25, 2014, 1:58 PM Ann Martin
Ċ 2014.7.1 BAAG SBHSA Rx.pdf
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Benefits-At-A-Glance - HSA Rx  320k v. 3 Jun 25, 2014, 1:58 PM Ann Martin
Ċ BCBSM Rx Formulary Quick Guide.pdf
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Summary Guide to Tiered Rx Program  590k v. 2 Jul 11, 2013, 7:35 AM Ann Martin
Ċ RX Claim Form (Nov. 2012).pdf
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Rx Reimbursement Form for Out-of-Pocket Expense (For claims dated Nov. 1, 2012 and after.)  138k v. 2 Oct 31, 2012, 10:42 AM Leslie Reynolds