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This website is a location for Benefit Liaisons to find special information to better serve their agency’s employees. All of the information on the left navigation bar will redirect you to the main Benefit Services Division website.

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2018 Open Enrollment Materials

2018 Open Enrollment- ADOA Liaison Training Presentation

2018 Open Enrollment - Active Appeal Form

2018 Open Enrollment- Active Cover Letter for Mailing

2018 Open Enrollment- Active Benefit Guide

2018 Open Enrollment- Active Expo Poster

2018 Open Enrollment- Retiree Cover Letter for Mailing

2018 Open Enrollment- Retiree Benefit Guide

2018 Open Enrollment- Retiree Expo Poster

2018 Open Enrollment- Retiree How to Enroll

2018 Open Enrollment- Mailing Envelope

2018 Open Enrollment- COBRA Enrollment

2018 Open Enrollment- Active Enrollment

2018 Open Enrollment- Retiree Appeal Form

2018 Open Enrollment - Employee Rate Change Memo

2018 Open Enrollment - Retiree Rate Change Memo

2018 Open Enrollment - Rate Change FAQ

2018 Open Enrollment - Flexible Spending Acct Limited Form - For HSA Plan and Dependent Care

2018 Open Enrollment - Flexible Spending Acct Form - For EPO/PPO Plans and Dependent Care

2018 Open Enrollment - HSA Payroll Deduction Authorization Form

 

2017 Information

Active State Employee Enrollment Form (ONLY if you do not have internet access)
Retired State Employee Enrollment Form
Flexible Spending Accounts Enrollment Form

Beneficiary Elections Form

Transition of Care Form
Declaration for Change Form
HSA Participants Only: Payroll Deduction Authorization Form

2017 Active State Employee Appeal Form
2017 Retired State Employee Appeal Form
2017 Reimbursement of Medical and Dental Form
2017 LWOP Form Effective 7/1/2017
2017 Payroll Calendar

2017 Enrollment Guide (pdf)

2017 COBRA Form
2017 PSPRS Waiting Period Calculator
2017 ASRS Waiting Period Calculator

 

2017 Open Enrollment

Liaison Training Presentations

2017 Open Enrollment - ADOA Liaison Training Presentation
Medical Insurance Options and Pharmacy Presentation
Dental and Vision Insurance Presentation
Flexible Spending Accounts, Life and Disability Insurance Presentation
Additional Vendors Presentation

Enrollment Guides

Active State Employee - 2017 Benefits Summary
Retired State Employee - 2017 Benefits Summary
2017 Benefits Guide

Enrollment Forms


2017 Open Enrollment Active State Employee Appeal Form
2017 Open Enrollment Retired State Employee Appeal Form

Active State Employee Enrollment Form (ONLY if you do not have internet access)

Retired State Employee Enrollment Form (ONLY if you do not have internet access)
COBRA Participants Enrollment Form

Medicare Generation PDP Enrollment Form
Flexible Spending Accounts Enrollment Form

Beneficiary Elections Form

Transition of Care Form

2017 Active State Employee Insurance Rates
2017 Retired State Employee Insurance Rates
2017 COBRA Participants Insurance Rates

2016 Information

Active State Employees

Health Impact Program (HIP)

2016 HIP Quarterly Report-Q2 (powerpoint presentation)
2016 HIP Quarterly Report (powerpoint presentation)
Mayo Clinic Healthy Living Coaching - Important deadline information
2016 HIP Point System
2016 HIP Factsheet
BeWell 2015 Health Impact Program Summary Report & 2016 Overview
Wellness Seminar Attendance Sheet

 

Employee Assistance Program (EAP)- GuidanceResources

Did you Know? messages
Life Events Flyers – Information about just-in-time GuidanceResources support for the following issues:
o   Separation and Divorce
o   Planning for Retirement
o   Planning for College
o   Planning for Elder Care
o   Navigating the Adoption Process
o   Moving
o   Getting Married
o   Having a Baby
o   Coping with Loss
o   Caring for an Elder
o   Dealing with Bullies
Manager Toolkit

2016 Benefits Enrollment Forms

Active Employee Enrollment Form
Active Appeal Form
Flexible Spending Account Enrollment Form
Limited Flexible Spending Account Enrollment Form
Declaration for Change Form
Beneficiary Elections Form
2016 COBRA Enrollment Form
Transition of Care Form

 

2016 Benefits Enrollment Guides
Active Employees 2016 Benefit Guide (including University Employees)

 

2016 Qualified Life Events
Qualified Life Events Presentation
Qualified Life Event and Mid-Year Changes Chart
Declaration for Change Form

 

2016 Rates

Active State Employee Insurance Rates

 

Other Documents

2016 LWOP Form
2016 Payroll Calendar
Retirement Waiting Period Calculator

 

Retired State Employees

2016 Benefits Enrollment Forms

Retired State Employee Enrollment Form
2016 Retired State Employee Appeal Form
2016 Retired State Employee Medicare GenerationRx Form
Declaration for Change Form
Beneficiary Elections Form
Transition of Care Form

 

2016 Benefits Enrollment Guides
Retired State Employee 2016 Benefit Guide

 

2016 Qualified Life Events
Qualified Life Events Presentation
Qualified Life Event and Mid-Year Changes Chart
Declaration for Change Form

 

2016 Rates

Retired State Employee Insurance Rates

 

COBRA Participants

2016 Benefits Enrollment Forms

COBRA Participants Enrollment Form
Declaration for Change Form
Beneficiary Elections Form
Transition of Care Form

 

2016 Benefits Enrollment Guides
COBRA Participants 2016 Benefit Guide

 

Other Documents

2016 LWOP Form
2016 Payroll Calendar
Retirement Waiting Period Calculator

 

 


Archives

2015 Resources Documents

Benefit Summary Guides
2016 Active State Employee Benefit Summary Guide
2016 Retired State Employee Benefit Summary Guide

 

Benefit Open Enrollment Guides
Active Employees 2016 Benefit Guide (including University Employees)
Retired State Employee 2016 Benefit Guide
COBRA Participant 2016 Benefit Guide

 

Enrollment Forms

2016 Active Employee Open Enrollment Appeal Form
2016 Retired State Employee Open Enrollment Appeal Form
Active Employee Open Enrollment Form
Retired Employee Open Enrollment Form
2016 COBRA Participant Open Enrollment Form
2016 Group PDP Open Enrollment Form
University Employees, Where to Enroll
Flexible Spending Account Open Enrollment Form
Limited Flexible Spending Account Open Enrollment Form
Transition of Care Form
Beneficiary Elections Form

 

Other Documents

2016 Payroll Calendar

 

Liaison Trainings

2016 Plan Year Open Enrollment Training

 

2014 Resource Documents

Benefit Guides
New Hire 2015 Benefit Guide
Active Employees 2015 Benefit Guide (including University)
Retired State Employee 2015 Benefit Guide
COBRA Participant 2015 Benefit Guide

 

Enrollment Forms
Active Employee Enrollment Form
Retired Employee Enrollment Form
COBRA Participant Enrollment Form
2015 Group PDP Enrollment Form
University Employees, Where to Enroll


Other Forms
Beneficiary Elections Form
Flexible Spending Account Enrollment Form
Limited Flexible Spending Account Enrollment Form
Transition of Care Form

 

Other Documents

2016 Payroll Calendar
2015 Payroll Calendar
LWOP Personal Payment calculator worksheet
2015 Active Rate Sheet
2015 Retiree Rate Sheet


Training Documents
2015 Plan Year Open Enrollment Presentation
Open Enrollment Expo Dates - Poster
Health Impact Program - Fact Sheet
Active State Employee Rates
Retired State Employee Rates
Medical & Pharmacy Presentation
Vision & Dental Presentation
FSA, Life, and Disability Presentation
Additional Vendors Presentation

 

2014 Member Satisfaction Survey

Active Employees: 2014 Member Satisfaction Survey
Retired State Employees: 2014 Member Satisfaction Survey


 

Archive ListServs

02.11.16 Arizona Department of Administration's Tucson Pre-Retirement Seminar
01.14.16 Important Announcement: New Tax Form for the 2015 Tax Year 1096-C
12.16.15 Health Impact Program Summary Report and 2016 Program Webinar
11.16.15 2016 Open Enrollment Appeals Process
11.09.15 Final Week for Open Enrollment
10.27.15 2016 Open Enrollment and Benefit Updates
10.21.15 2016 Arizona Deparment of Administration's Phoenix Pre-Retirement Seminars
10.08.15 New Hires:  Enrolling in New Hire Benefits and Open Enrollment during Open Enrollment Period
10.08.15 Plan Year 2016 Open Enrollment for Active Employees
09.03.15 2016 HIP Call to Action
09.01.15 2016 Open Enrollment Benefit Liaison Meetings
08.10.15 Benefit Liaison Survey
08.06.15 Payroll Update
07.31.15 HIP Benefit Liaison Meetings
07.06.15 Benefit Services Division Announcement
06.01.15 Arizona Department of Administration's Tucson Pre-Retirement Seminar
05.04.15 2015 National Women’s Health Week – HIP Activities for State Employees
04.16.15 Updated Contact Information for ADOA HRD-Benefit Services
04.02.15 Annual Member Satisfaction Survey Notification
04.01.15 2015 Register for the Health Impact Program (HIP) to enter into a drawing to win an iPad
03.30.15 2015 Dependent Eligibility Audit
03.13.15 Annual Member Satisfaction Survey Notification
03.09.15 Various Benefit Changes
01.07.15 Arizona Department of Administration's Tucson Pre-Retirement Seminar
11.24.14 2015 Open Enrollment Appeals Process
11.13.14 2015 Arizona Department of Administration’s Phoenix Pre-Retirement Seminars
10.31.14 2015 Medical Flexible Spending Account Limit increase
10.29.14 Same-Sex Spouse - Coverage in Benefit Options Plans; FMLA Eligibility
10.20.14 New Hire Benefit Enrollment and Open Enrollment Guidelines for Benefit Liaisons
10.08.14 Plan Year 2015 Open Enrollment for Active Employees
09.04.14 2015 Updated Contact Information for ADOA Benefit Services
08.25.14 2015 Open Enrollment Benefit Liaison Meetings
05.14.14 ADOA Reminder Tucson Pre-Retirement Seminar
05.14.14 ADOA Tucson Pre-Retirement Seminar
05.12.14 National Women's Health Week
04.17.14 HRIS Availability
04.17.14 HRIS Availability
03.10.14 Provider Performance Survey Notification
01.27.14 Affordable Care Act – Changes to Employee Health Insurance Eligibility
01.09.14 Arizona Department of Administration’s Tucson Pre-Retirement Seminar 
12.24.13 HRIS Availability
12.02.13 2014 Arizona Department of Administration’s Phoenix Pre-Retirement Seminars
11.26.13 2014 Open Enrollment Appeals Process
10.21.13 2013 Mayo Clinic Health Assessment
10.15.13 Plan Year 2014 Open Enrollment for Active Employees
09.30.13 Health Insurance Marketplace Notice
09.16.13 New Hire Benefits Entry Form and Y.E.S. New Hire Self Services
09.03.13 Open Enrollment Benefit Liaison Meetings
09.03.13 Benefit Options Wellness 2013 Flu Vaccine Program
07.18.13 New Hire Benefits Entry Form and Effective Dates for Employees Impacted by Elimination of the 90-Day Wait
07.03.13 Y.E.S. New Hire Self Service Unavailable during the Elimination of 90-Day Waiting Period
06.26.13 Fiscal Year End Processing in HRIS
06.25.13 Important News Regarding Paychecks
06.06.13 Tucson Pre-Retirement Seminar
05.08.13 2013 Dependent Eligibility Audit
05.08.13 Women's Health Week
04.11.13 "Not Me" Diabetes Screening for Employees
03.01.13 Provider Performance Survey Notification
02.15.13 State-Sponsored Discount Program

ListServ Archive

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