2011 - Retiree Health Care
The annual Open Enrollment period for Retiree 2012 benefits begins
November 1, 2011 and will end November 30, 2011.
2011 Retiree Health Care
2011 Plan Options & Rates for Henrico County Retirees
Non-Medicare Eligible Retirees
- 2011 Southern Health Booklet
- 2011 Preventive Services Flyer
- Vaccine Program
- 2011 Direct Draft Authorization Form for Southern Health
- 2011 Southern Health Enrollment/Change Form
- 2011 Deductible Q&A
- Age 26 Q&A
- Compliance Notice
- Waiver of Retiree Health Coverage
Medicare Eligible Retirees
- 2011 UnitedHealthcare Benefit Highlights (PPO—in Virginia)
- Benefit Highlights—High Plan (PPO)
- Benefit Highlights—Low Plan (PPO)
- 2011 UnitedHealthcare Provider Directory (PPO—in Virginia)
- 2011 UnitedHealthcare Formulary—Please note, if you plan to use mail order, you will need new prescriptions from your doctor to accompany your first mail order form to UnitedHealthcare’s pharmacy administrator, Prescription Solutions.
- 2011 UnitedHealthcare Prescription Mail Order Form
- 2011 UnitedHealthcare PPO Evidence of Coverage (EOC)
- 2011 Medicare Advantage FAQs
- 2011 EFT form for United Healthcare (Direct Draft)
- 2011 UnitedHealthcare Enrollment Form
- Waiver of Retiree Health Coverage
2011 Retiree Dental Information:
- 2011 Delta Dental Retiree Rates
- 2011 Delta Dental Brochure
- 2011 Delta Dental Enrollment/Change Form
- DeltaCare Provider List
- 2011 Dental Direct Draft Authorization Form
- Delta Dental Claim Form
- Waiver of Retiree Dental Coverage
Vera Huxtable, Payroll & Benefits Supervisor
804-652-3622
Connie Arnett, Senior Benefits Analyst
804-652-3625
