Preservation Parks of Delaware County
Overview
Preservation Parks of Delaware County is proud to provide a comprehensive and competitive benefits package to all of its qualified employees. This website contains summaries and links to the various components of these coverages and should be used as a portal to your benefit needs.
In most cases, you have up to 30 days from your eligibility date to complete all of the necessary applications and forms to be retroactively enrolled in the benefits as outlined below. Failure to complete these materials in the allotted time will result in you forfeiting your eligibility for these benefits until the next open enrollment period unless you have a qualifying event.
Tony Benishek
2656 Hogback Road
Sunbury, OH 43074
Benefit Summary (Effective 12/1/13) – High level summary of the medical and prescription drug benefits and what is covered.
Certificate of Coverage (Effective 12/1/13) – Detailed information about your medical and prescription benefits including coverages, exclusions and limitations.
Summary of Benefits and Coverage (Effective 12/1/13 or 12/1/14) This is the 8 page benefits summary required to be made available under the Affordable Care Act. Also included is the Universal Glossary of Terms which is not specific to your plan but is very helpful for understanding various terms and how your plan works.
Preservation Parks of Delaware County is contracting with Infinisource to handle the administration and notification of your rights under COBRA and ability to continue the insurance if a qualifying event occurs. While PPODC is aware of events such as terminations of employment, it is YOUR responsibility to notify the Human Resources of any qualifying events so they can in turn notify Anthem.
Anthem Enrollment Application – All new or currently unenrolled employees are required to complete this form if you are electing coverage.
Anthem Change Form – Use this form ONLY if you are making changes to your current coverage such as an address or plan. If you need to add a dependent you must use the Enrollment Application.
Affidavit of Dependency – For those wanting to continue their children’s medical & prescription drug coverage between ages 26 and 28, this form must be completed, notarized and turned into Tony Benishek
in the Human Resources office within 31 days of their qualifying event.
IMPORTANT! – You have 30 days from any qualifying event such as marriage, the birth of a child or change in dependent status to make changes to your plan and notify Tony Benishek. Failure to do so could result in a loss of coverage and having to wait until the annual open enrollment!
Claim Forms:
Anthem’s network providers are responsible for submitting any claim forms to Anthem on your behalf. However, if you have services provided by a non-network provider, you will need to pay that provider directly and complete the claim forms below for any reimbursements.
Non-Network Medical Claim Form
Non-Network Prescription Claim Form
Prescription Mail Order Form – Complete this form and attach your prescription to receive up to a 90 day supply of your maintenance prescription medications. Additional information can be found HERE.
Mail completed forms to:
Express Scripts
Home Delivery Service
PO Box 66772
St. Louis, MO 63166-6772
Anthem Website: www.anthem.com
Medical and Prescription
Questions: 800.552.9159
Hours: 8:30am to 6:00pm, EST
MyAnthem– Anthem’s member and consumer self-service web site that provides a single source for online benefits and health related information. Here you can access your personalized health care and benefits information, complete health risk assessments and have access to other tools.
Online Provider Lookup – Find doctors, hospitals and other in-network providers by specialty, location or name. Under the plan selection filters. The Plan/Network is “Blue Access (PPO)”.
LiveHealth Online – New online doctor service which allows you an alternate choice for those times when you need to see the doctor, but just can’t get there. The cost to you is the same as $20 Primary Care Physician copay. For more information please refer to their video, Frequently Asked Questions and online setup information.
Future Moms – Anthem’s free nurse coaching, education, information and support for expectant mothers.
SpecialOffers@Anthem – With this program you can receive discounts on products and services that help promote better health and well-being. And, there’s no extra cost to you.
24/7 NurseLine – Anthem’s free registered nurse assistance line you can call to help decide how to handle a medical issue by calling 888.249.3820
Prescription Drug Information:
Prescription Drug Information – Links to Anthem’s Prescription Drug listing, formulary, specialty medications and tiers.
Benefit Summary – High level summary of the dental benefits and what is covered.
Certificate of Coverage – Detailed description of your benefits and exclusions.
Preservation Parks of Delaware County is contracting with Infinisource to handle the administration and notification of your rights under COBRA and ability to continue the insurance if a qualifying event occurs. While PPODC is aware of events such as terminations of employment, it is YOUR responsibility to notify the Human Resources of any qualifying events so they can in turn notify Principal.
Enrollment Application (Fillable version in Word) – All new or currently unenrolled employees are required to complete this form and turn it into Human Resources if you are electing coverage.
IMPORTANT! – You have 30 days from any qualifying event such as marriage, the birth of a child or change in dependent status to make changes to your plan and notify Tony Benishek. Failure to do so could result in a loss of coverage and having to wait until the annual open enrollment period!
Submitting dental claims – Most providers will submit claims for their services directly to Principal on your behalf. However, if you use an out of network provider you may need to pay first and send you information in for reimbursement. If that’s the case, no claim form is needed but you will need (If they need additional information they will contact you):
1. The provider’s itemized statement and
2. A photocopy of the front and back of your ID card so Principal can identify you.
Send this information to Principal at:
Principal Life Insurance Company
PO Box 10357
Des Moines, IA 50306-0357
Principal’s dental website where you can access your claims, find providers and get various forms:
Website: www.principal.com
Customer Service: 800.843.1371
Find a Dentist – In-network dental providers that have agreed to a lower fee schedule and will save you money.
Benefit Summary – High level summary of the vision benefits and what is covered.
Certificate of Coverage – Detailed description of your benefits and exclusions.
Preservation Parks of Delaware County is contracting with Infinisource to handle the administration and notification of your rights under COBRA and ability to continue the insurance if a qualifying event occurs. While PPODC is aware of events such as terminations of employment, it is YOUR responsibility to notify the Human Resources of any qualifying events so they can in turn notify Superior Vision.
Non-Network Vision Claim Form – Complete and mail this form along with a detailed copy of your bill to Superior Vision for reimbursement.
Superior Vision Customer Service Phone: 800.507.3800
How To – Instructions on how to create your online account, print ID cards, view your benefits and find a vision provider.
Online Provider Lookup – Find in-network providers online. [Instructions]
Miscellaneous Information:
– Importance of routine eye exams
– Quick list of retail providers
Benefit Summaries – High level summary of benefits and coverages.
-
Group Life – Employer paid
- Voluntary Life – Employee paid
- Short-Term Disability – Employer paid (Discontinued 5-1-15)
- Long-Term Disability – Employer paid (Effective 5-1-15)
Certificates of Coverage – Detailed information about the coverage including limitations and exclusions.
-
Group Life – Employer paid
- Voluntary Life – Employee paid
- Short-Term Disability – Employer paid (Discontinued 5-1-15)
- Long-Term Disability – Employer paid (Coming soon)
Enrollment Application (Fillable version in Word) – All new or currently unenrolled employees are required to complete this form and turn it into Human Resources if you are electing coverage.
Supplemental / Optional Term Life Insurance Rates – Summary of the monthly life and AD&D rates for you, your spouse and children. Note: The rates for your spouse are based on their own attained age.
Evidence of Insurability Form – This form must be completed if you:
- Want to enroll in coverage as a late entrant (ie, during open enrollment), or
- As an employee that’s already enrolled in voluntary life and during open enrollment want to elect a higher level of coverage for you or your spouse.
Long-Term disability FAQ document
In the event of a claim you must see Tony Benishek in the Human Resources Office for a current form.
Website: www.principal.com
Customer Service: 800.843.1371
Milestone Benefits Agency, Inc.
PO Box 2038
Powell, OH 43065
Local Phone: 614-431-9540
Toll-Free Phone: 877-990-4622
Fax: 614-844-5364
Milestone Benefits Agency: www.milestonebenefits.com
Contact information signs – Content information about this website and how to contact your representatives at Milestone Benefits Agency, Inc.
Direct: (614) 318-5220
E-mail: Marie@milestonebenefits.com
Kent Bermingham Jr.
Direct: (614) 318-5485
E-mail: kentjr@milestonebenefits.com
Disclaimer: The information contained on this site serves as a resource for the employees and administrators of your employer and in some instances only contains an overview of the benefits, provisions, limitations and exclusions of these programs. Information can sometimes change and may not be current on this site. In all instances, if the information contained on this site conflicts with the applicable plan documents or carrier administration of these programs, the plan documents and their administrative policies will prevail. Each company reserves the right to change these benefits at any time without prior notice and at their own discretion.
Our Location:
PO Box 2038
Powell, Ohio 43065
Contact Info:
Hours of Operation: