REMINDER
Annual Open Enrollment for Health Plan
If you wish to add or drop health coverage effective September 1st, you must complete request for change during open enrollment
If you wish to add or drop health coverage effective September 1st, you must complete request for change during open enrollment
EE Contributions Effective 9-1-2024
Enrollment Form Effective 9-1-2024
Determine your Federal Income Tax (FIT) Bracket plus 7.65% FICA Taxes to calculate your Pre-Tax Savings
2024 Federal Income Tax (FIT) Brackets
(Enrollment form required for new employees or if making a change to benefits during Open Enrollment)
POLICIES / BOOKLETS
Employee Health Benefits Effective 9/1/2024
Summary of All Employee Health Benefits-9-1-2024 Power Point Presentation
- Medical Plan Comparison 9-1-2024
- Schedule of Coverage – Gold G652CHC (820) SBC – Gold PPO G652CHC-820
- Schedule of Coverage – Silver S665CHC (834) SBC – Silver PPO S665CHC-834
- Virtual Visits (MD Live)
- Member Rewards (NEW)
- BCBS Global Core (Blue Card Access)
- Formulary List August 2024
- Mail Order Pharmacy
- Specialty Pharmacy
- MyBlueRxTX (Virtual Medicine Cabinet)
- Dental Summary
- Vision Summary
- Life / AD&D Summary and Long Term Disability Summary
- Vol. Term Life/AD&D Summary
- Vol. Term Life/AD&D Monthly Rate Table
- Voluntary Term Life Enrollment Form
Colonial Life Supplemental Benefit Summaries
Summary of Colonial Life Supplemental Insurance
- Supplemental Insurance -Per Pay – Accident, Cancer, MedBridge
- Colonial Cost Examples for Accident, MB, & Cancer with Tax Reform
- Colonial Critical Illness Example
- Colonial Life Taxability of Claim Payments
- Accident Insurance Brochure and Outline of Coverage
- Cancer Insurance Brochure
- Outline of Coverage – Cancer 1000 (Enrolled prior to 9/1/2016)
- Outline of Coverage – CancerAssist (Enrolled on/after 9/1/2016)
- Specified Disease Rider
- Critical Illness Brochure and Outline of Coverage
- Disability Brochure and Outline of Coverage (3 month policy)
- Medical Bridge / Hospital Confinement Brochure
- Hospital Confinement Colonoscopy Benefit
- MB 3000 Outline of Coverage (Enrolled prior to 9/1/2019)
- IMB 7000 Outline of Coverage (Enrolled on/after 9/1/2019)
- Term Life Brochure
- Universal Life Brochure
Colonial supplemental benefits are portable even if you terminate your employment with JBI, LTD at your original issue age. Your benefits can be customized to fit your individual needs. Call HR or your benefits broker for more information.
Other General Information
- On Call International 24 Hour Travel Assistance
- InfoArmor Identity Theft Restoration
- ACI Specialty Benefits Bereavement Support Services
- Blue Access for Members (BAM)
- Blue Access for Members Dashboard
- BCBSTX Blue Access Mobile App
- BCBS Provider Finder
- Blue 365 Discount Programs
- BCBS Preventive Services
- Well on Target Wellness
- 24 / 7 Nurse
- Preauthorization
- Special Beginnings (maternity support)
- Hinge Health (joint/back pain)
- Glucose Meter
- RSL Beneficiary Form
- Colonial Life Beneficiary Form
- Colonial Life Request for Service Change Form
- BCBS Standard Authorization Form to Release Protected Health Information (PHI)
Important Notifications
- General Notice Of COBRA Continuation Coverage Rights
- Medical Prescription Drug Important Notice
- Notice of Special Enrollment Rights
- Premium Assistance under Medicaid & the Children’s Health Insurance Program
- WHCRA Notification
- Newborns’ & Mothers’ Act Notice
Carrier Contact Information
MEDICAL & DENTAL INSURANCE – BCBS of Texas |
Medical Policy Number: 120534 Dental Policy Number: 299985 |
BCBS Website: | www.bcbstx.com |
BCBS Global Core Website: | www.bcbsglobalcore.com |
Prescription – Prime Therapeutics Website: | www.myprime.com |
Member Services Department | 800/521-2227 |
BCBS Global Core | 800/810-2583 or collect 804/673-1177 |
Prime Member Services | 877/794-3574 |
BCBS Pharmacy Advocate | 800/423-1973 (24/7) |
Medical Preauthorization | 800/441-9188 |
Mental Health / Chemical Dependency | 800/528-7264 |
Nurse 24/7 | 800/581-0368 |
VISION INSURANCE – Vision Service Plan (VSP) |
Vision Account Number: 30069274 |
Website: | www.vsp.com |
Service Department | 800/877-7195 |
LIFE/AD&D & DISABILITY INSURANCE – Reliance Standard Life |
LTD Policy: 121171 Life/AD&D Policy: 147555 Vol. Term Life/AD&D Policy: VG 182338 |
Website: | www.reliancestandard.com |
RSL Customer Service | 800/351-7500 |
Identity Theft Recovery | 855/246-7347 |
24 Hour Travel Assistance | 800/456-3893 |
Bereavement Support Services | 855/775-4357 (24/7) |
SUPPLEMENTAL INSURANCE – Colonial Life |
Colonial Account Number: F5525035 |
Website: | www.coloniallife.com |
Customer Service Center | 800/325-4368 |
FSA ADMINISTRATION – United Healthcare |
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Website: | www.uhcservices.com |
Benefit Services (FSA) | 877/797-7475 |