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Debbie Fleck, Flower Mound Insurance Agent

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Broker for AVT’s Employee
Health Benefit Plan
THE WEBSITE IS UNDER CONSTRUCTION TO INCLUDE THE 2018 CHANGES

Effective January 1, 2017

Employee Contributions per Pay Period (bi-weekly) for your Medical, Dental, & Vision Coverage

EE Only $77.43
EE & Spouse $166.32
EE & Child(ren) $155.40
Family $243.19
The voluntary term life rates will remain the same, however, if you changed age brackets in the 2016 calendar year, you will be subject to the new age bracket effective 1/1/2017.

BENEFIT BOOKLETS

BCBS Medical for 2017*
BCBS Dental
VSP Vision
Unum Basic Life/AD&D
Greater GA Life Short Term Disability
Greater GA Life Long Term Disability
UNUM Vol. Term Life-AD&D
FSA SPD/PD

* Effective 1/1/2018 Medical plan moved from BCBS to UHC.

AVT Logo

Health Benefits Summaries Effective January 1, 2017


AVT Power Point Presentation 2017

The summaries represent a brief summary of benefits and is not the contract. Please refer to your Booklets (the Contract) for a complete description of covered services, limitations, and exclusions. You may also contact the carrier for more information.


Supplemental Life Insurance

Colonial Example for Accident, MB, & Cancer with 2018 Tax Reform (Tax Reform Tax Brackets 22%, 12%, & 24% / previously 25%, 15%, & 28%)                                                   Colonial Critical Illness Example

* Cancer 1000 will no longer be offered to new participants enrolling for the supplemental cancer policy. Effective April 2016 Colonial’s CancerAssist policy will be offered. Participants enrolled for Cancer 1000 can remain enrolled with Cancer 1000 but it will no longer be offered to new participants.

Accident Brochure and Outline of Coverage
Medical Bridge Brochure and Outline of Coverage
Cancer Brochure

Supplemental policies may vary based on enrollment location.


Other Helpful Information


Enrollment


Important Notifications


Carrier Contact Information

The Medical terminated with BCBS effective 1/1/2018 and moved to United Healthcare.

BCBSGreater Georgia Life

Medical & Dental Case Number:

GA6820

STD & LTD Policy Number:

GA2878

General Customer Service (855) 397-9267
Medical (855) 397-9267
Dental (800) 627-0004
Pharmacy (800) 824-0898
Pre-certification (800) 722-6614
Disability (800) 232-0113
Future Moms (866) 664-5404
SelfHelpWorks (877) 719-9860
BlueCard Worldwide (800) 810-2583 or collect (804) 673-1177
24 Hour Nurse (888) 724-2583
Online Registration (866) 755-2680
SeniorLink (866) 797-2336
ConditionCare (800) 638-4754
Resource Advisor (888) 209-7840
Member Claim Form Member Authorization
Dental Claim Form BlueCard Worldwide Int’l Claim Form
Prescription Claim Form Home Delivery Medication Form
STD Claim Form LTD Claim Form

VSP

Policy Number:

30012024

Vision (800) 877-7195
Vision Out of Network Claim Form

UNUM

Voluntary Term Life & Voluntary AD&D Policy Number:

133739

Basic Life/AD&D Policy Number:

209956

General Customer Service (800) 421-0344
Supplemental Term Life (800) 445-0402
24 Hour Travel Assistance (800) 872-1414
Life Planning (800) 422-5142
Life Claim Form Beneficiary Form
Life Portability Form

Colonial Life

How to File a Wellness Claim

Wellness screenings can be filed online, by telephone, or through the automated customer service if completed within 12 months.
Policyholder Services (800) 325-4368
Request for Service Conversion Request
Change of Beneficiary Form Universal Claim Form
Accident Claim Form MedicalBridge Claim Form
Cancer Claim Form Critical Illness Claim Form
Wellness Claim Form Over 1 Year Old  

ADP

Flexible Spending Accounts (FSA’s)

General Customer Service (800) 654-6695
Health Care Spending Claim Form Dependent Care Spending Claim Form
August 20th, 2018 by The Diamond Benefit Group