Annual Benefit Enrollment Period
May 1, 2019 - May 17, 2019
Health Benefits: Effective 7/1/2019 - MVP enrollment forms are only required for the following:
- If you are currently enrolled in the MVP PPO Plan and want to make a change (add/remove dependents) - you must complete the MVP enrollment form (enrollment form is 3 pages)
- If you are not currently enrolled in the health plan and want to enroll in the health plan -- you must complete the MVP Enrollment form (enrollment form is 3 pages)
Opt Out: of Health Benefits Effective 7/1/2019
- An opt-out form must be completed each plan yea rthat you elect to opt-out
Flexible Spending: Medical or Dependent Care
- To participate in the 7/1/2019 - 6/30/2020 plan year you must complete the BRI Enrollment form
- Please refer to the plan summary for plan information (FSA max contribution $2,700.00/DCA max contribution $5,000.00)
PLEASE DO NOT "PONY" FORMS TO ADMINISTRATION. HR staff will collect forms from your building secretary on 5/17/19 afternoon.
|MVP Healthcare PPO Information - (888) 687-6277|
|Mail Order Form | CVS caremark - (800) 364-6331|
|MVP Health Care Presentation 4/10/18|
Living Well Newsletter: http://view.mvphealthcare.net/?qs=797529a9506cd0e6240a5e885a237781cdddb0870d5fe0cb91b0aac06c7ef683acd6cce24d5c5ac47cb9f3946f2d9fbf4e206b24cbaf92b281421d94aa24c3d13ae2c6ba02a55772
Delta Dental | 800-932-0783
Davis Vision | Eligible Employee Benefit | 800-999-5431
Flexible Spending Accounts: Benefit Resource Inc.
Benefit Resource, Inc. | 800-473-9595
Stay Current with Updates and Tips from the
For more information, contact MaryJane Carpenter, Employee Benefit Coordinator, at 951 Hoffman Street, Elmira, New York 14905 or at (607) 735-3005.