Page 43 - Apricity Benefits Guide
P. 43
2020
Apricity Legal Notices
If you live in one of the following states, you may be eligible for assistance paying your employer
health plan premiums. The following list of states is current as of July 31, 2019. Contact your State
for more information on eligibility:
ALABAMA—Medicaid FLORIDA—Medicaid
Website: http://myalhipp.com/ Website: http://lmedicaidtplrecovery.com/hipp/
Phone: 855.692.5447 Phone: 877.357.3268
ALASKA—Medicaid GEORGIA—Medicaid
The AK Health Insurance Premium Payment Program Website: https://medicaid.georgia.gov/
Website: http://myakhipp.com/ health-insurance-premium-payment-program-hipp
Phone: 866.251.4861
Email: CustomerService@MyAKHIPP.com Phone: 678.564.1162 ext 2131
Medicaid Eligibility:
http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx
ARKANSAS—Medicaid INDIANA—Medicaid
Website: http://myarhipp.com/ Healthy Indiana Plan for low-income adults 19-64
Phone: 855.MyARHIPP (855.692.7447) Website: http://www.in.gov/fssa/hip/
Phone: 877.438.4479
All other Medicaid Website:
http://www.indianamedicaid.com
Phone 800.403.0864
COLORADO—Health First Colorado (Colorado’s Medicaid IOWA—Medicaid
Program) & Child Health Plan Plus (CHP+)
Health First Colorado Website: Website:
https://www.healthirstcolorado.com/ http://dhs.iowa.gov/Hawki
Health First Colorado Member Contact Center: Phone: 800.257.8563
800.221.3943/State Relay 711
CHP+: https://www.colorado.gov/paciic/hcpf/
child-health-plan-plus
CHP+ Customer Service: 800.359.1991/ State Relay 711
KANSAS—Medicaid NEW HAMPSHIRE—Medicaid
Website: http://www.kdheks.gov/hcf/ Website: https://www.dhhs.nh.gov/oii/hipp.htm
Phone: 785.296.3512 Phone: 603.271.5218
Toll free number for the HIPP program:
800.852.3345, ext 5218
KENTUCKY—Medicaid NEW JERSEY—Medicaid and CHIP
Website: https://chfs.ky.gov Medicaid Website: http://www.state.nj.us/humanservices/
Phone: 800.635.2570 Medicaid Phone: 609.631.2392
dmahs/clients/medicaid/
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 800.701.0710
LOUISIANA—Medicaid NEW YORK—Medicaid
Website: Website:
http://dhh.louisiana.gov/index.cfm/subhome/1/n/331 https://www.health.ny.gov/health_care/medicaid/
Phone: 888.695.2447 Phone: 800.541.2831
MAINE—Medicaid NORTH CAROLINA—Medicaid
Website: http://www.maine.gov/dhhs/oi/public-assistance Website: https://medicaid.ncdhhs.gov/
/index.html
Phone: 919.855.4100
Phone: 800.442.6003
TTY: Maine relay 711
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 43
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
Apricity Legal Notices
If you live in one of the following states, you may be eligible for assistance paying your employer
health plan premiums. The following list of states is current as of July 31, 2019. Contact your State
for more information on eligibility:
ALABAMA—Medicaid FLORIDA—Medicaid
Website: http://myalhipp.com/ Website: http://lmedicaidtplrecovery.com/hipp/
Phone: 855.692.5447 Phone: 877.357.3268
ALASKA—Medicaid GEORGIA—Medicaid
The AK Health Insurance Premium Payment Program Website: https://medicaid.georgia.gov/
Website: http://myakhipp.com/ health-insurance-premium-payment-program-hipp
Phone: 866.251.4861
Email: CustomerService@MyAKHIPP.com Phone: 678.564.1162 ext 2131
Medicaid Eligibility:
http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx
ARKANSAS—Medicaid INDIANA—Medicaid
Website: http://myarhipp.com/ Healthy Indiana Plan for low-income adults 19-64
Phone: 855.MyARHIPP (855.692.7447) Website: http://www.in.gov/fssa/hip/
Phone: 877.438.4479
All other Medicaid Website:
http://www.indianamedicaid.com
Phone 800.403.0864
COLORADO—Health First Colorado (Colorado’s Medicaid IOWA—Medicaid
Program) & Child Health Plan Plus (CHP+)
Health First Colorado Website: Website:
https://www.healthirstcolorado.com/ http://dhs.iowa.gov/Hawki
Health First Colorado Member Contact Center: Phone: 800.257.8563
800.221.3943/State Relay 711
CHP+: https://www.colorado.gov/paciic/hcpf/
child-health-plan-plus
CHP+ Customer Service: 800.359.1991/ State Relay 711
KANSAS—Medicaid NEW HAMPSHIRE—Medicaid
Website: http://www.kdheks.gov/hcf/ Website: https://www.dhhs.nh.gov/oii/hipp.htm
Phone: 785.296.3512 Phone: 603.271.5218
Toll free number for the HIPP program:
800.852.3345, ext 5218
KENTUCKY—Medicaid NEW JERSEY—Medicaid and CHIP
Website: https://chfs.ky.gov Medicaid Website: http://www.state.nj.us/humanservices/
Phone: 800.635.2570 Medicaid Phone: 609.631.2392
dmahs/clients/medicaid/
CHIP Website: http://www.njfamilycare.org/index.html
CHIP Phone: 800.701.0710
LOUISIANA—Medicaid NEW YORK—Medicaid
Website: Website:
http://dhh.louisiana.gov/index.cfm/subhome/1/n/331 https://www.health.ny.gov/health_care/medicaid/
Phone: 888.695.2447 Phone: 800.541.2831
MAINE—Medicaid NORTH CAROLINA—Medicaid
Website: http://www.maine.gov/dhhs/oi/public-assistance Website: https://medicaid.ncdhhs.gov/
/index.html
Phone: 919.855.4100
Phone: 800.442.6003
TTY: Maine relay 711
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 43
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
