Page 38 - Apricity Benefits Guide
P. 38
2020
Apricity Legal Notices
For More Information About Your Options Under Medicare Prescription Drug Coverage
More detailed information about Medicare plans that offer prescription drug coverage is in the
“Medicare & You” handbook. You will get a copy of the handbook in the mail every year from
Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
Visit www.medicare.gov.
Call your State Health Insurance Assistance Program (see the inside back cover of your copy
of the “Medicare & You” handbook for their telephone number) for personalized help.
Call 1-800-MEDICARE (800.633.4227). TTY users should call 877.486.2048.
If you have limited income and resources, extra help paying for Medicare prescription drug
coverage is available. For information about this extra help, visit Social Security on the web at
www.socialsecurity.gov, or call them at 800.772.1213 (TTY 800.325.0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you
may be required to provide a copy of this notice when you join to show whether or not you have maintained
creditable coverage and whether or not you are required to pay a higher premium (a penalty).
Date October 15, 2019
Name of Entity/Sender Stormy Speaks
Contact—Position/Ofice HR Generalist
Address 1001 Hawkins Street
Nashville, TN 37203
Phone Number 615.600.3524
Nothing in this notice gives you or your dependents a right to coverage under the Plan. Your (or
your dependents’) right to coverage under the Plan is determined solely under the terms of the
Plan.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 38
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
Apricity Legal Notices
For More Information About Your Options Under Medicare Prescription Drug Coverage
More detailed information about Medicare plans that offer prescription drug coverage is in the
“Medicare & You” handbook. You will get a copy of the handbook in the mail every year from
Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
Visit www.medicare.gov.
Call your State Health Insurance Assistance Program (see the inside back cover of your copy
of the “Medicare & You” handbook for their telephone number) for personalized help.
Call 1-800-MEDICARE (800.633.4227). TTY users should call 877.486.2048.
If you have limited income and resources, extra help paying for Medicare prescription drug
coverage is available. For information about this extra help, visit Social Security on the web at
www.socialsecurity.gov, or call them at 800.772.1213 (TTY 800.325.0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you
may be required to provide a copy of this notice when you join to show whether or not you have maintained
creditable coverage and whether or not you are required to pay a higher premium (a penalty).
Date October 15, 2019
Name of Entity/Sender Stormy Speaks
Contact—Position/Ofice HR Generalist
Address 1001 Hawkins Street
Nashville, TN 37203
Phone Number 615.600.3524
Nothing in this notice gives you or your dependents a right to coverage under the Plan. Your (or
your dependents’) right to coverage under the Plan is determined solely under the terms of the
Plan.
Table of Contents Your Quick Guide to Savings and Group Auto and Home Insurance .33
About Your Beneits Program. . . . . . .2 Spending Accounts .............16 Group Legal Services ............33
Beneits Basics ...................3 Dental Beneits .................18 Employee Assistance Program ....34
Medical/Prescription Drugs Beneits . 6 Dental Plan Summary ............20 Medicare Part D Creditable
Comparing Medical Plan Options ..7 Vision Beneits ..................21 Coverage Notice ...............35
First Stop Health ................11 Voluntary Disability Insurance .....22 Premium Assistance Under Medicaid
Medical Plan Summary ..........12 Life and AD&D Insurance ........25 and the Children’s Health Insurance
Program (CHIP) .................42
Pharmacy Plan Summary .........13 Voluntary Accident Insurance ....29 Contact Information .............46 38
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
