Plan Year 2013 Information


PLAN YEAR 2013 MATERIALS

BOOKLETS AND CHARTS

ACTIVE STATE EMPLOYEES

PY 2013 Active State/NSEGroup Booklet

PY 2013 Active State Comparison Chart


NON STATE EMPLOYER GROUPS

PY 2013 Active State/NSEGroup Booklet

PY 2013 NSE Group Comparison Chart


RETIREE/DIRECT BILL MEMBERS

PY 2013 Retiree/Direct Bill Booklet

PY 2013 Retiree/Direct Bill NON Medicare Plans - Chart 1

PY 2013 Retiree/Direct Bill MEDICARE Plans - Chart 2


COBRA

PY 2013 COBRA Booklet

PY 2013 Active State COBRA Rates

PY 2013 NSE Group COBRA Rates

FORMS

ACTIVE STATE EMPLOYEES

PY 2013 Active State Enrollment Form

PY 2013 Active State Change Form

PY 2013 FSA Enrollment/Change Form

PY 2013 ASI (Vendor) - FSA Claim Form

PY 2013 HSA (With Plan C) - Enrollment and Change Form


NON STATE EMPLOYER GROUPS

PY 2013 NSEGroup Enrollment Form

PY 2013 NSEGroup Change Form

PY 2013 HSA With Plan C Enrollment and Change Form


RETIREEE/DIRECT BILL MEMBERS

PY 2013 Retiree/Direct Bill Enrollment/Change Form

PY 2013 Retiree/Direct Bill ACH Enrollment Form

PLAN YEAR 2013 VENDOR BENEFIT DESCRIPTIONS

Active State, Non State Employer Group and
NON- MEDICARE ELIGIBLE Retiree/Direct Bill

Blue Cross Blue Shield of Kansas |

2013 Plan A

2013 Plan B

2013 Plan C



Coventry |

2013 Plan A

2013 Plan B

2013 Plan C


UHC |

2013 Plan A |

2013 Plan B |

2013 Plan C


CVS Caremark |

2013 With Plans A & B

2013 With Plan C


Delta Dental |

2013 Delta Dental


Superior Vision |

2013 Basic

2013 Enhanced


MEDICARE ELIGIBLE
Retiree/Direct Bill

Blue Cross Blue Shield - Sr. Plan C |

2013 Senior Plan C



Coventry Health Care - Advantra |

2013 Coventry Advantra With Rx

2013 Coventry Advantra Without Rx



SilverScript |

2013 SilverScript Benefit Description  

2013 SilverScript Evidence of Coverage

2013 SilverScript Formulary