The City will provide 1095-C tax forms that include the employee and their covered family members enrolled in any City medical plan annually . Employees are required to provide each covered family members ’ Name and Social Security Number as it appears on the family member ’ s Social Security Card .
Health
I M P O R T A N T
N O T I C E S
1095- C I N F O R M A T I O N
The City will provide 1095-C tax forms that include the employee and their covered family members enrolled in any City medical plan annually . Employees are required to provide each covered family members ’ Name and Social Security Number as it appears on the family member ’ s Social Security Card .
M E D I C A R E C A R D R E Q U I R E M E N T
The Centers for Medicare and Medicaid have established coverage rules to determine which plan is considered primary and secondary when an individual becomes eligible for Medicare . Benefits under the City ’ s plans may be reduced when an employee or a covered family member becomes eligible for Medicare based on Federal regulations . It is the employee ’ s responsibility to notify Human Resources of any covered family member ’ s eligibility for Medicare and to provide a copy of the individual ’ s Medicare card .
R E Q U I R E D
N O T I C E S
The
following required notices are available on the Human Resources Portal → Documents and Forms → Required Notices , or through your Benefits Specialist . If you are viewing electronically , you can click each link below to access the notice directly .
Health
Insurance Marketplace Notice for FT Employees Children ’ s Health Insurance Program ( CHIP ) Notice Glossary of Health Coverage and Medical Terms HIPAA Privacy Notice Medicare Part D Creditable Coverage Notice Newborn ’ s Act Disclosure Notice No Annual Dollar Limits on Essential Health Benefits Provider Choice Notice – The Patient Protection and Affordable Care Act Special Enrollment Notice Women ’ s Health and Cancer Rights Act of 1998 Notices
City of Arlington / EMPLOYEE BENEFITS GUIDE 2021
9