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- Notification of Disclosure
Notification of Disclosure
Certificate of Coverage
This document explains the health benefits you and your dependents have under the plan. It details the services that will and will not be covered. Services that are not covered are called exclusions. The actions you have to take to receive the health benefits such as paying a copay, meeting a deductible, or using particular health care providers are called conditions.
- Basic Life/AD&D Certificate of Coverage
- Dental Low Plan Certificate of Coverage
- Dental High Plan Certificate of Coverage
- Dental Platinum Plan Certificate of Coverage
- Long-Term Disability Certificate of Coverage
- Vision Plan Certificate of Coverage
COBRA Continuation of Health Coverage
This notice has important information about your right to Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage, which is a temporary extension of coverage under the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to get it.
Legal Notices Affecting Your Health Plan Coverage
The Woman's Health Cancer Rights Act of 1998, Notice of Special Enrollment Rights, Statement of ERISA Rights, Medicare Creditable Coverage Notice, Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP), Health Insurance Marketplace; Notice of Coverage Options.
Medical Plan Document
The plan document tells plan participants about the benefits they are entitled to under the medical plan and provides guidelines to be used by the plan administrator in decision-making when it comes to plan operations.
- The City of Savannah Employee Group Medical Plan - TCN Network
- The City of Savannah Employee Group Medical Plan - PHCS Network
Summary of Benefits & Coverage
An easy-to-read summary of each medical plan offering that lets you make apples-to-apples comparisons of costs and coverage between health plans. You can compare options based on price, benefits, and other features that may be important to you.
- Basic Plan Option Summary of Benefits
- Plus Plan Option Summary of Benefits
- Summary of Benefits Glossary
Section 125 Plan
A section 125 plan is the only means by which an employer can offer employees a choice between taxable and nontaxable benefits without the choice causing the benefits to become taxable.
Wellness Program Information & Disclosures
This documents explain how the City's wellness program works, and what is required to be compliant and receive an incentive.