Active Employees
EVERYTHING YOU NEED AS AN EMPLOYEE
Employees' Group Insurance covers active employees with the State of Wyoming, University of Wyoming, Wyoming Community Colleges and Natrona County School District.
CONTACT INFO
BENEFIT INFORMATION AND PLAN BOOKLETS
- Cigna Health Plan Book
- Delta Dental Book
- Standard Life Insurance Plan Book
- Flexible Benefits Book
- Voluntary Benefits Brochure
- Short/Long Term Disability Book
- 2018 Summary Benefit Comparison (SBC) 500 Deductible (Updated 10/4/2017)
- 2018 Summary Benefit Comparison (SBC) 900 Deductible (Updated 10/4/2017)
- 2018 Summary Benefit Comparison (SBC) 2000 Deductible (Updated 10/4/2017)
- 2018 Summary Benefit Comparison (SBC) 1500 High Deductible Health Plan (HDHP) (Updated 10/4/2017)
PREMIUM RATES & CALCULATORS
APPLICATION & ENROLLMENT
- Active Benefits Application Health, Dental and Life Insurance Enrollment or Changes.
- Voluntary Benefits Application Vision & Disability Enrollment or Changes.
- 2018 Flexible Benefits Election Form
- 2019 Flexible Benefits Election Form
- Flex Benefits Change Form
- Link to Genworth site When prompted enter: Group Name: statewy Access code: groupltc
- 2018 Health Savings Account Election Form
- Long Term Disability Application Link
OTHER FORMS
- Medical Reimbursement & Dependent Care Claim Form (Updated 4/25/2017)
- 2018 Flexible Benefit Payment Schedule Claims deadlines & check mail dates.
- Qualifying Event Matrix What benefits can be changed based on a qualifying event.
- MedImpact Direct Rx Mail Order Form For use on prescriptions that did not go through a retail pharmacy.
- MedImpact Claim Form Used for manual submission of prescription reimbursement.
- Delta Dental Claim Form Used to send your claim to Delta Dental when your provider is non-participating.
- Direct Payment Authorization
- Vision Out of Network Reimbursement Claim Form
- Short Term Disability Insurance Claim Form The Standard Company 1-800-368-2859
- Long Term Disability Claim Form The Standard Company 1-800-368-1135
- Cigna Claim Form Used to send medical claims to Cigna.
- HIPAA Privacy Authorization Form
WEBSITE LINKS
- MedImpact Direct Mail Order & Specialty Pharmacy
- Health Savings Account Questions Frequently Asked Questions
WEBSITE LINKS
Cigna
- mycigna.com
- 1-800-685-1060
Delta Dental of Wyoming
- dentadental.com
- 307-632-3313 or
- 1-800-735-3379
Vision Service Plan
- vsp.com
- 1-800-877-7195
MedImpact Pharmacy
- medimpact.com
- 1-800-788-2949