Page 3 - Interwest Benefits Guide
P. 3
Health Plan EnrollmentForms
Term Definition Interwest
The time of year when your insurance rates
Effective Date January 1
are released and your plan becomes active
Period of time when employees may make
Open Enrollment Date December
changes to their elected benefit options
Period of time which must pass before your
st
Waiting Period 1 of the month following 30 days
health care coverage can begin
Ensure your doctor participates in the
HAP HMO Network Search Your Doctor HERE
network before seeking care
For new hires or employees with a qualifying
HAP Enrollment Form event who would like to enroll in Medical Download HERE
Insurance
HAP Waiver Form For employees declining medical coverage Download HERE
• HAP HMO Silver $4,000 HERE
HAP Plan Summaries Summary of Benefits and Coverage
• HAP HMO $5,500 HDHP HERE
OptiMed Enrollment Form Download HERE
For employees electing a benefit over the
Principal Application & Waiver Download HERE
guaranteed issue amount
Principal Statement of Health Download HERE
Flexible Spending Account - set aside funds on
TASC FSA a pre-tax basis to be used for qualifying Download HERE
healthcare and/or dependent care expenses
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