Important information for 2022-2023 Retiree Benefits:
If you have life insurance coverage as a retiree, please complete and return
the beneficiary designation form sent with this mailing.
Mail beneficiary form and/or FY24 Retiree Open Enrollment Change Form to
the following address by 5:00 p.m., Monday, May 15, 2023:
Or Email to: firstname.lastname@example.org
Important Employee Benefits Notices: Paper copies are also available, free of charge, by calling 928-679-7100. These notices include but are not limited to the following: Summary of Benefits and Coverage (SBC) for each medical plan option. Reminder Notices about: the Health Insurance Marketplace, Reminder to provide Social Security Number for all dependents enrolled for medical coverage, Women’s Health and Cancer Rights Act, Newborns’ and Mothers’ Health Protection Act, HIPAA Privacy Notice, Medicare Part D Notice of Creditable Coverage, Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP), COBRA Coverage Reminder, Special Enrollment and Mid-Year Changes to Health Plan Elections, and more.