Telephone Area Code Map
Area Codes in Numerical Sequence (U.S. & Canada). Telephone Area Code Map. New Codes Effective Dates Old Codes. Overlay Code. New Code. Area Codes do not
Tennessee Area Codes
TENNESSEE COUNTIES BY CATEGORY. Tennessee Area Codes. Putnam. Hamblen. Hancock. Clay. Trousdale. Grundy. Lake. Lewis. Macon. DeKalb. Crockett.
European Commission
23 mai 2022 {COM(2022) 613 final} - {SWD(2022) 640 final} ... covered by the EU ETS (buildings road ... area of Croatia covered by Natura 2000 in.
Summary of Benefits and Coverage Completed Example
30 nov. 2021 name social security number
Planning and Development Code Map Book
The purpose of Planning and Development Code is to divide the city into areas of such size shape and number best suited to carry out the land use regulations
Camrose Management Area Map - Codes of Practice: Pipelines
613. GIBBONS. (643). Fort. Saskatchewan activity location: the Code provisions and the applicable Management Area Map (the map) including.
Federal Communications Commission DA 16-613 Before the
3 juin 2016 designated market areas (DMAs)3 and considerations for fostering increased ... who reside in the same zip code as that subscriber or person.
Common Area Completion Security Agreement [§11018.5(a)(2) or
[§11018.5(a)(2) or 11230]. RE 613 (Rev. 7/15). SUBDIVISIONS. ASSOCIATION. NAME OF OWNERS ASSOCIATION. ADDRESS CITY
DISCLAIMER: THIS VERSION OF THE MMREF-1 PUBLICATION IS
If you specify "U.S. Postal Service" as your Preferred Method of Notification in Use Employment Code M (Military) to report only Social Security covered ...
ORDINANCE NO. 613 AN ORDINANCE OF THE CITY OF
1 janv. 2017 TO AMEND BRISBANE MUNICIPAL CODE TITLE 15 BUILDINGS AND CONSTRUCTION
IBEW AECA
FAMILY HEALTH
IBEW LOCAL 613 & CONTRIBUTING EMPLOYERS
FAMILY HEALTH PLAN
ALL PARTICIPANTS MUST COMPLETE THE ENROLLMENT BY NOV 30th /d[^d/DdKEZK>>J DURING ANNUAL ENROLLMENT EACH YEAR, IT IS IMPORTANT THAT YOU:UPDATE
CHOOSE
ENROLL
YOU MUST COMPLETE ENROLLMENT IN ORDER FOR
YOUR DEPENDENTS TO HAVE COVERAGE IN 2022
2022 OPEN ENROLLMENT
Page 2
ALL PARTICIPANTS MUST COMPLETE THE ENROLLMENT BY NOV 30th THIS YEAR WE ARE USING AN ONLINE ENROLLMENT APPLICATION THAT CAN BE ACCESSED RIGHT INSIDE YOUR MEMBER PORTAL t JUST A SINGLE SIGN ON TO ENROLL AND VIEW INFORMATION ON YOUR BENEFITS, WORK HISTORY AND MORE!ENROLLMENT IS FAST AND EASY t
oe oe oe oe oe oe oe oe oeʹ If you fail to complete enrollment, you will be defaulted to Employee Only coverage for 2022 t this means your dependents will not be eligible for benefits effective January 1, 2022 unless you complete your enrollment and you select to cover them.2022 OPEN ENROLLMENT
Page 3
ALL PARTICIPANTS MUST COMPLETE THE ENROLLMENT BY NOV 30thSUMMARIES OF BENEFITS AND COVERAGE (SBCs):
REMEMBER:
x x x xTo request a special enrollment period or to obtain more information about your special enrollment rights,
contact the Fund Office at 1-800-922-1613. CURRENT DENTAL BENEFITS WILL STILL BE PROVIDED THROUGH CIGNA FOR BOTH COVERAGE OPTIONSThe above comparison just highlights basic benefits and is not intended to fully describe all benefit coverages.
HIGHLIGHT COMPARISON OF 2022 FAMILY HEALTH PLAN COVERAGE OPTIONS COVERAGE UNDER BOTH OPTIONS IS FOR IN-NETWORK PROVIDERS ONLY (plus Non-Network Emergency Services)CIGNA OAP KAISER HMO
NETWORK UTILIZED CIGNA OPEN ACCESS PLUS KAISER PERMANENTE HMO IF YOU NEED TO SEE THE DOCTOR Calendar Year Deductible does not applyPrimary Care You pay $35 You pay $20
Specialist You pay $45 You pay $35
Mental Health You pay $35 You pay $20
Virtual Visit/Telemedicine You pay $35 You pay $0
WHEN YOU RECEIVE PREVENTIVE CARE Calendar Year Deductible does not apply ACA Preventive Care Services You pay $0 You pay $0IF YOU NEED A PRESCRIPTION DRUGS
ACA PREVENTIVE CARE DRUGS
PRESCRIPTION DEDUCTIBLE
You pay $0, no deductible
$25 per individual per calendar yearYou pay $0, no deductible
None RETAIL (30-day supply) After deductible: If filled at Kaiser Facility:Tier 1: Generic You pay $10 You pay $10
Tier 2: Preferred Brand You pay greater of $25 or 25% You pay $25 Tier 3: Non-Preferred Brand You pay greater of $25 or 25% Not coveredHOME DELIVERY (90-day supply)
Tier 1: Generic You pay $30 You pay $20
Tier 2: Preferred Brand You pay greater of $75 or 25% You pay $50 Tier 3: Non-Preferred Brand You pay greater of $75 or 25% Not coveredSPECIALTY (30-day supply)
Specialty Medications You pay greater of $25 or 25% You pay $25IF YOU NEED OTHER MEDICAL SERVICES
CALENDAR YEAR DEDUCTIBLE (CYD)
Individual $750 $250
Family $2,500 $750
MAXIMUM OUT-OF-POCKET
Individual $6,350 $6,350
Family $12,700 $12,700
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