2023 AtlantiCare Benefits Booklet

Contacts

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

Policy Type

Vendor Name

Contact Information

Access Center

AtlantiCare

1-888-569-1000

1-800-355-2583 Group # 086317 1-800-355-2583 Group # 086317

Medical

Horizon BCBS (Engaged Plan)

Medical

Horizon PPO

Atlantic City, 1-609-441-7088 Galloway, 1-609-404-7444 Manahawkin, 1-609-704-6800 MedImpact, 1-833-229-3595 1-800-433-6825 www.horizonblue.com/dental Basic Group # 11-851V5 Plus Ortho Group # 21-851V5

Prescription

MedImpact

Dental

Horizon Dental

1-800-638-3120 www.myuhcvision.com Group # 911483 1-800-307-0230 MyFlexDollars.com 1-800-307-0230 mybenefitdollars.com

Vision

United Healthcare Vision

FSA

Baker Tilly

COBRA

Baker Tilly

Commuter Benefit

Baker Tilly

1-800-307-0230

Life & AD&D

NJHA/MetLife

1-609-275-4186

Long Term Disability

The Hartford

1-800-549-6514

1-609-677-7766 LOA@atlanticare.org Self-administered programs 1-609-677-6019 1-609-407-2381 Self-administered programs

AtlantiCare Leave and Short Term Disability Department

Leave of Absence and Short Term Disability

AtlantiCare Workers’ Compensation Department

Workers' Compensation

Payroll

AtlantiCare Payroll Department

1-609-407-2333

1-800-367-5690 AtlantiCare code is 15107 www.theworknumber.com

Employment Verification

The Work Number

47