GROUP INSURANCE  HOME PAGE

HUMAN RESOURCES HOME PAGE

STATE HOME PAGE

State of Wyoming A&I Human Resources Division Employees' Group Insurance 2001 Capitol Ave., Room 106, Cheyenne, WY 82002 Phone:  800-891-9241 (Wyoming Only) or 307-777-6835 Fax:  307-777-7685

	Video Presentation concerning Changes to your Plan  Requires a video player on your computer - click to "open" & wait for download to play.  Depending on your connection download time will vary.
	¶   Active Employee Presentation            Click to play Employees Video
	¶   Retiree Presentation           Click to play Retirees Video
Benefit Information & Plan Booklets
ACTIVE EMPLOYEES
	¶   $350; $750; $2500 Deductible Health Plan – Summary of Benefits
	¶   $1500 High Deductible Health Plan – Summary of Benefits
	¶   2009 Health Plan Benefit Book
	¶   Dental Plan Book
	¶   2009 Preferred Drug List
	¶   Hartford Life Insurance Plan Book
	¶   Flexible Benefits Plan Book
RETIREES
	¶   2009 Health Plan Benefit Book
	¶   Dental Plan Book
	¶   2009 Preferred Drug List
	¶   Hartford Life Insurance Plan Book
Voluntary Benefits
	¶   Voluntary Benefits Brochure
VISION - VSP
	¶    Find a Local Provider
	¶    Benefits Summary
	o      Out of Network Reimbursement Claim Form
	o      Enrollment form – Active
	o      Enrollment form – Retirees
LONG-TERM CARE – GENWORTH
	¶    Link to Genworth site  When prompted enter:           Group Name: statewy           Access code: groupltc
SHORT-TERM DISABILITY & LONG TERM DISABILITY
	¶    The Standard - Plan Book and Claim Form
	o      Enrollment Form
Premium Rates & Calculators
ACTIVE EMPLOYEES
	¶    2010 Rate Calculator (Excel)
	¶    2009 Rate Calculator (Excel)
	¶    2010 Rate Sheet - Includes COBRA
	¶    2009 Rate Sheet - Includes COBRA
	¶    Life Insurance Rates
RETIREES
	¶   2010 Rate Sheet
	¶   2009 Rate Sheet
	¶   Life Insurance Rates
Member Forms
ACTIVE EMPLOYEES
	¶    Health Insurance Application
	¶    Dental Insurance Application
	¶    Life Insurance Application
	¶    Vision Application
	¶    Health Savings Account (HSA) Election Form
	¶    2010 Flexible Benefit Enrollment Form
	¶    2009 Flexible Benefit Enrollment Form
	¶    Flexible Benefits Change Form
RETIREES
	¶    Health Insurance Application
	¶    Dental Insurance Application
	¶    Life Insurance Application
	¶    Vision Application
OTHER
	¶    Medical Reimbursement & Dependent Care Claim Form
	¶    2009 Flexible Benefit Payment Schedule
	¶    Great West – Long Claim Form
	¶    Great West – Short Claim Form
	¶   Cigna Rx Claim Form
	¶   Cigna Mail Order Rx Order Form
	¶    Delta Dental Claim Form
	¶    Hartford Life Conversion of Benefits Form
	¶    Personal Representative Authorization Form
	¶    Direct Payment Authorization Information & Form
Benefit Specialist Form
	¶    Termination, Less 80, Transfer Form
	¶    New Benefited Employee Checklist
	¶    Hartford Life Conversion of Benefits Form
Advisory Board
	¶    List of Members
	¶    Advisory Board Minutes - 2-19-09
Wellness
	¶    Agency Wellness Coordinators
	¶    WOW – Wyoming on Wellness Website
Publications
	¶    Open Enrollment Guide 2009
	¶    Voluntary Benefits Brochure
	¶    Benefit Press Newsletter - September 2009
	¶    Wellness Discount Brochure
	¶    Benefit Press Newsletter - June 2009
	¶    Benefit Press Newsletter - March 2009
	¶    How to read your Explanation of Benefits (EOB) from Great West
	¶    Getting Ready to Retire Brochure
	¶    HSA Brochure
	¶    Hartford Life - Will & Estate Planning Brochure
	¶    Privacy Notice
	¶    Group Insurance Rules
Links
	¶   Great West
	¶   Delta Dental
	¶   Express Scripts
	¶   Express Scripts Cost Preview
	¶   HSA Frequently Asked Questions
	¶    Hartford Life Will & Estate Planning
	¶    Wyoming Health Fairs
	¶    Medicare
	¶    HealthierWY
	¶    WOW – Wyoming on Wellness

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