Oakland County Employee Benefits

Choose one of the following:

Employees (Including Command Officers) Hired on/after 05/31/2003

Mailing Address:
Oakland County
Employee Benefits
2100 Pontiac Lake Road 41W
Waterford, MI
48328-0440

Employees (Including Command
Officers) Hired on/after 05/31/2003

	Health Plan Booklet - Includes your health plan enrollment form and information on various benefits available to you.

	Medical Options Comparison Sheet - Compares the provisions of the medical plans available to you.

	Employee Contributions - Your bi-weekly, pre-tax deduction for the medical plan you choose. *Effective* *01-01-2009*

Retirement

Reimbursement Accounts

	Health Care Reimbursement Form - the form to use to request reimbursement for your flexible spending account.

	Dependent Care Reimbursement Form - the form to use to request reimbursement for your flexible spending account.

	Flexible Spending Account (FSA) Calculator - Use the FSA Calculator to help plan your per pay FSA deduction as well as view potential tax savings.

	Direct Deposit Form and Instructions for Reimbursement Accounts - the form to use to enroll in direct deposit for reimbursement.

	www.MyRSC.com - Go to MyRSC to view your current FSA account balances and claims payment history on-line. Download forms or use the FSA calculator to view your potential savings.

New Hire Forms

	Health Plan Enrollment Form - Use this form to select your health plan.

	Coordination of Benefits - Complete this form so we know what other coverage you or your dependents may have.

	HIPAA Privacy Notice - Describes how the privacy of your medical information is protected under the federal law.

	Deferred Compensation Information

	401 Retirement Overview

	COBRA Notice - Explains the right to continue medical care for you or your dependents in the event of termination, separation, divorce, etc.

	Life Insurance Beneficiary - To change the beneficiary on your life insurance in the event of your death.

	Medical Options Comparison Sheet - Compares the provisions of the medical plans available to you.

Miscellaneous

	HIPAA Privacy Notice - Describes how the privacy of your medical information is protected under the federal law.

	Short-Term Disability Forms - What you need to apply for Short-Term Disability.

	HAP Drug Formulary This link will take you directly to the most current HAP drug formulary.

	Consumer Toolkit - To allow the subscriber to access detailed information on your dental coverage.

	OakFit - Oakland County's Wellness Program for Employees Many programs, ideas and recipes available with the click of your mouse. Print and view walking maps, monthly awareness programs and information!

	BCBS Master medical Claim Form - The form and instructions you need to file a master medical claim.

	DeltaUSA Dental Plan Summaries DeltaUSA Dental Plan High Option 9936-1 DeltaUSA Dental Plan Standard Option 9936-2 DeltaUSA Dental Plan Modified Option 9936-3

	Navitus Prescription Benefit Manager (Effective April 1, 2008) - www.Navitus.com – Your link to your Prescription Benefit Manager (PBM) - Physician Prescription Fax Form - www.WellDyneRX.com – the form you need to enroll in mail order or order a new prescription - Direct Member Reimbursement Form – the form you need to submit for reimbursement - Drug Formulary – Please click here to see the most up-to-date drug formulary from Navitus

Change Kit - forms to complete due to marriage, divorce, birth, etc.

	Instructions

	Membership and Record Change - add or remove members on your health coverage

	Membership and Record Change Supplement - also complete this when removing members

	COBRA notice

	Life Insurance Beneficiary Form

	Deferred Compensation Beneficiary Form

	Family Status Change - change coverage due to marriage, divorce, birth, etc.

	Name/Address/Marital Status Change

and complete one of these...
	ICMA Beneficiary Change Form (401 Retirement)

	Nomination of Retirement Beneficiary(Defined Benefit Retirement Plan)

FAQs

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