The Yahnis Company Model Notices and Employee Documents
This webpage houses all of the Yahnis Company model notices along with your Employee Benefits Summary Plan Description for the 2016-2017 benefit year that starts on October 1, 2016. Also, on this page are each carriers certificate of coverage for your benefit. We have also included summaries of these documents for your review along with some carrier forms below. If you need any more information please contact Human Resources or your Clarke & Company Benefits representative below.
Enrollment Materials
BlueCross BlueShield
- Summary of Benefits & Coverage
- Benefit Summary
- Medical Claim Form
- Prescription Drug Claim Form
- Prescription Drug Mail Order Form
- Preferred Drug List
- Specialty Drug List
- Step Therapy Drug List
- Prior Authorization Drug List
- Quantity Management Drug List
- Healthy Incentive Account Flyer
- Blue Care on Demand Video Visits
Delta Dental
Physicians Eyecare Plan
Sunlife
- Summary Plan Description
- Evidence of Insurability Form
- Long Term Disability Claim Packet-Employee Form
- Long Term Disability Claim Packet-Employer Form
- Long Term Disability – Attending Physician Form
- Short Term Disability Claim Packet
- Life Insurance Claim Packet
- Death Benefit Claim Packet
- Life Insurance Conversion & Portability Notice
- Voluntary Life Insurance Portability Notice
Pro Benefits
- Benefits Summary Plan Description
- Flexible Spending Account Plan Document
- Claims Reimbursement Form
- Flexible Spending Reimbursable Expenses
Compliance
- CHIPRA Notice 1 Page
- Creditable Coverage Disclosure Notice Part D
- Exchange Notice
- WHCRA Model Notice
Questions About Your Yahnis Company Benefits
If you have any questions concerning your current benefit package, any future benefits, or any other benefit information that you may need, please contact HR or our benefit team at Clarke & Company Benefits. Our contact information is below.
Laura Howell – Account Manager
Toll Free: 888-540-9403
Columbia: 803-253-6997
To email click on name above.