Medical - Family Coverage

Medical – Family Coverage
Medical – Family Coverage2018-12-13T08:43:19+00:00

Please consult the benefits summary you received from human resources for plan costs and deductible amounts.

Learn More about HDHP and HSA

 

thumbnail of Meridian Universal Enrollment and Waiver Form – Fillable

thumbnail of How to Enroll in PPO

thumbnail of How to Enroll in HDHP

When electing medical coverage, you MUST also complete an Affidavit for the Tobacco-Free Incentive Plan, in order to qualify for the reduced premiums. If this form is not returned, you will be enrolled at the base plan premium with Loss of Tobacco-Free Incentive.

thumbnail of Attachment_Tobacco Free Incentive Form 2019 — Fillable

thumbnail of How to Complete Tabacoo Incentive

When electing medical coverage, you MUST also complete a Spousal Surcharge Form to determine whether you are subject to the spousal surcharge added to your premiums. If this form is not returned, the spousal surcharge will be added automatically.

thumbnail of Spousal Surcharge Form

thumbnail of How to Complete Spousal Surcharge

When enrolling in our PPO Medical plan, you have the option to elect a Flexible Spending Account, for pre-tax deductions to cover out of pocket expenses. (FOR PPO PLAN ONLY)

thumbnail of Flex Spending Enrollment Form (FSA)

thumbnail of How to Enroll in FSA

When enrolling in our HDHP Medical plan, you have the option to elect a Health Savings Account, for pre-tax deductions to cover out of pocket expenses. (FOR HDHP PLAN ONLY)

thumbnail of Meridian HSA Election Form – Fillable

thumbnail of How to Enroll in HSA

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