Page 44 - Apricity Benefits Guide
P. 44
2020
Apricity Legal Notices
MASSACHUSETTS—Medicaid and CHIP NORTH DAKOTA—Medicaid
Website: http://www.mass.gov/eohhs/gov/ Website:
departments/masshealth/ http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 800.862.4840 Phone: 844.854.4825
MINNESOTA—Medicaid OKLAHOMA—Medicaid and CHIP
Website: Website: http://www.insureoklahoma.org
https://mn.gov/dhs/people-we-serve/seniors/health-care Phone: 888.365.3742
/health-care-programs/programs-and-services
/other-insurance.jsp
Phone: 800.657.3739
MISSOURI—Medicaid OREGON—Medicaid
Website: Website: http://healthcare.oregon.gov/Pages/index.aspx
http://www.dss.mo.gov/mhd/participants http://www.oregonhealthcare.gov/index-es.html
/pages/hipp.htm Phone: 800.699.9075
Phone: 573.751.2005
MONTANA—Medicaid PENNSYLVANIA—Medicaid
Website: Website:
http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP http://www.dhs.pa.gov/provider/medicalassistance/
Phone: 800.694.3084 healthinsurancepremiumpaymenthippprogram/index.htm
Phone: 800.692.7462
NEBRASKA—Medicaid RHODE ISLAND—Medicaid and CHIP
Website: http://www.ACCESSNebraska.ne.gov Website: http://www.eohhs.ri.gov/
Phone: 855.632.7633 Phone: 855.697.4347, or 401.462.0311 (Direct RIte Share
Lincoln: 402.473.7000 Omaha: 402.595.1178 Line)
NEVADA—Medicaid SOUTH CAROLINA—Medicaid
Medicaid Website: https://dhcfp.nv.gov Website: https://www.scdhhs.gov
Medicaid Phone: 800.992.0900 Phone: 888.549.0820
SOUTH DAKOTA - Medicaid WASHINGTON—Medicaid
Website: http://dss.sd.gov Website: https://www.hca.wa.gov/
Phone: 888.828.0059 Phone: 800.562.3022 ext.15473
TEXAS—Medicaid WEST VIRGINIA—Medicaid
Website: http://gethipptexas.com/ Website: http://mywvhipp.com/
Phone: 800.440.0493 Toll-free phone: 855.MyWVHIPP (855.699.8447)
UTAH—Medicaid and CHIP WISCONSIN—Medicaid and CHIP
Medicaid Website: https://medicaid.utah.gov/ Website:
CHIP Website: http://health.utah.gov/chip https://www.dhs.wisconsin.gov/publications/
Phone: 877.543.7669 p1/p10095.pdf
Phone: 800.362.3002
VIRGINIA—Medicaid and CHIP
Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 800.432.5924
CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 855.242.8282
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 44
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
Apricity Legal Notices
MASSACHUSETTS—Medicaid and CHIP NORTH DAKOTA—Medicaid
Website: http://www.mass.gov/eohhs/gov/ Website:
departments/masshealth/ http://www.nd.gov/dhs/services/medicalserv/medicaid/
Phone: 800.862.4840 Phone: 844.854.4825
MINNESOTA—Medicaid OKLAHOMA—Medicaid and CHIP
Website: Website: http://www.insureoklahoma.org
https://mn.gov/dhs/people-we-serve/seniors/health-care Phone: 888.365.3742
/health-care-programs/programs-and-services
/other-insurance.jsp
Phone: 800.657.3739
MISSOURI—Medicaid OREGON—Medicaid
Website: Website: http://healthcare.oregon.gov/Pages/index.aspx
http://www.dss.mo.gov/mhd/participants http://www.oregonhealthcare.gov/index-es.html
/pages/hipp.htm Phone: 800.699.9075
Phone: 573.751.2005
MONTANA—Medicaid PENNSYLVANIA—Medicaid
Website: Website:
http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP http://www.dhs.pa.gov/provider/medicalassistance/
Phone: 800.694.3084 healthinsurancepremiumpaymenthippprogram/index.htm
Phone: 800.692.7462
NEBRASKA—Medicaid RHODE ISLAND—Medicaid and CHIP
Website: http://www.ACCESSNebraska.ne.gov Website: http://www.eohhs.ri.gov/
Phone: 855.632.7633 Phone: 855.697.4347, or 401.462.0311 (Direct RIte Share
Lincoln: 402.473.7000 Omaha: 402.595.1178 Line)
NEVADA—Medicaid SOUTH CAROLINA—Medicaid
Medicaid Website: https://dhcfp.nv.gov Website: https://www.scdhhs.gov
Medicaid Phone: 800.992.0900 Phone: 888.549.0820
SOUTH DAKOTA - Medicaid WASHINGTON—Medicaid
Website: http://dss.sd.gov Website: https://www.hca.wa.gov/
Phone: 888.828.0059 Phone: 800.562.3022 ext.15473
TEXAS—Medicaid WEST VIRGINIA—Medicaid
Website: http://gethipptexas.com/ Website: http://mywvhipp.com/
Phone: 800.440.0493 Toll-free phone: 855.MyWVHIPP (855.699.8447)
UTAH—Medicaid and CHIP WISCONSIN—Medicaid and CHIP
Medicaid Website: https://medicaid.utah.gov/ Website:
CHIP Website: http://health.utah.gov/chip https://www.dhs.wisconsin.gov/publications/
Phone: 877.543.7669 p1/p10095.pdf
Phone: 800.362.3002
VIRGINIA—Medicaid and CHIP
Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 800.432.5924
CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 855.242.8282
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 44
Flexible Spending Accounts ......14 Voluntary Critical Illness Insurance . 31
