Benefits Off-Boarding Summary Disclaimer: This chart is designed to be only a summary of benefits and does not contain all the terms and conditions of the various programs. The actual operation of each of the plans is governed by the appropriate plan document. Insurance Benefits Type Contact Coverage end date Health State Health Plan If separating If separating the 1-888-234-2416 before the 16th 16th or later - - Last day of the Last day of month of following month separation after separation Dental MetLife 1-855-676-9441 Vision Superior Vision last day of the month of separation 1-800-507-3800 (if full premium is collected), or last day of the prior month of separation Cancer / Critical Allstate Benefits (if full premium is not collected) Illness* 1-866-232-1517 Term Life / Accident Voya: 1-877-464-5111 and Disability* Flexible P & A Group: Flexible Spending Accounts are Spending 1-866-916-3475 eligible for use until the end of the Accounts month following date of termination or cancellation. Participants may submit claims for the entire month or use their card. A full deduction may be taken for the month of termination. Other Life American United Life (AUL): Last day of the month of separation (if full premium is collected) Insurance* 704-687-8134 COBRA: Letter to be mailed to home address with enrollment options for health, dental, vision and flexible spending accounts Supplemental Liberty Mutual The Standard Date of separation Disability (TSERS) (ORP) 1-800-291-0112 1-800-378-4668 *Contact the provider for continuation/portability options
Benefits Off-Boarding Summary Disclaimer: This chart is designed to be only a summary of benefits and does not contain all the terms and conditions of the various programs. The actual operation of each of the plans is governed by the appropriate plan document. Insurance Benefits Type Contact Coverage end date Health State Health Plan 1-888-234-2416 If separating before the 16th - Last day of the month of separation If separating the 16th or later - Last day of following month after separation Dental Vision Cancer / Critical Illness* Term Life / Accident and Disability* MetLife 1-855-676-9441 Superior Vision 1-800-507-3800 Allstate Benefits 1-866-232-1517 Voya: 1-877-464-5111 last day of the month of separation (if full premium is collected), or last day of the prior month of separation (if full premium is not collected) Flexible Spending Accounts P & A Group: 1-866-916-3475 Flexible Spending Accounts are eligible for use until the end of the month following date of termination or cancellation. Participants may submit claims for the entire month or use their card. A full deduction may be taken for the month of termination. Other Life Insurance* American United Life (AUL): 704-687-8134 Last day of the month of separation (if full premium is collected) COBRA: Letter to be mailed to home address with enrollment options for health, dental, vision and flexible spending accounts Supplemental Disability Liberty Mutual The Standard (TSERS) (ORP) 1-800-291-0112 1-800-378-4668 Date of separation *Contact the provider for continuation/portability options
Benefits%20Offboarding.docx