Page 21 - 2020 Benefit

You will now see your current benefits listed in an easy-to-use format

Current 2019 Benefits

... Health Plan 1000
Employ.,Co.t , Empio,.,Co9t
·-- -~ $1 31 ......
Yu
Yu
$32 65
.-o ...
._,..
ApprO'o'Nf
01/01/2019
01/01/2019
_,.,
Empk)yttOnly Employtt Only
$13.50 $1.00
Short Term D1sabil1ty VisK>nPlan
-Cofl hl~C•
$000 No S3162 y.,
lff.ctlwDat• (ff.c:fhe0a't9
01/01/2019 ApprO'tt'd 0110,no,9
,_.., -
$87 50 Wttldy Benefit EmployttOnly
$3.03 $3.00
Vol life Employee
,_,..co.,
$000 No
E~O.te
01/01/2019
c-...
$5000000
$1962
I

VIEW CONFIRMATION
Additionally, you can see details of your confirmation by clicking "View Confirmation."
Details included in this confirmation are as follows:

 Employee Information

 In Progress Benefits

 Requested Benefits

 Approved Benefits

 Declined/Denied Benefits

 Terminated Benefits

 Dependent Information
 Employee Signature and Totals