Learn more information about HACC's benefits as well as how to enroll.
- 2018 Benefit Sessions & Workshops (pdf) - Email Cody Burt to register today!
- Basic Description of HACC Benefits (pdf)
- My Plan Advisor
- 2018 Open Enrollment FAQs (pdf)
- Health Savings Account (HSAs)
- All Health Plan Costs (pdf)
- Domestic Partner Medical Costs (pdf)
Comparing the Plans
- How The Plans Work (pdf)
- HACC Insurance Basics (pdf)
- Plan Summaries
- PPO 500 (Premium) Plan Highlights (pdf)
- PPO 500 Summary of Benefits and Coverage (pdf)
- CareConnect Plan Highlights (pdf)
- CareConnect PPO Summary of Benefits and Coverage (pdf)
- High Deductible Health Plan (HDHP) Plan Hightlights (pdf)
- High Deductible Summary of Benefits and Coverage (pdf)
- Vision Plan Highlights (pdf)
- Dental Plan Highlights (pdf)
Plan Contact Information
- Carrier and Third-Party Administrator Contact Information (pdf)
- Capital Blue Member Resources
After you complete your enrollment, be sure to complete and submit all required forms to:
Office of Human Resources
- Spousal Surcharge Form (pdf)
- Complete this form every year if you are covering your spouse on your medical plan.
- Medical Cash Opt-Out Form (pdf)
- Complete this form every year and submit proof of other coverage if you are waiving HACC's medical coverage. You will not receive the $1,500 waiver until both the form and proof of other coverage are received.
- Evidence of Insurability Form (pdf)
- Complete this form only if you are increasing your coverage or enrolling in Voluntary Life or AD&D for the first time.
- Dependent Verification (pdf)
- Submit this information only if you are enrolling a dependent for the first time.
- Domestic Partner Affidavit (pdf)
- Complete this form only if you are adding a domestic partner for the first time.
- Medicare Notices (pdf)
- Annual Legal Notices (pdf)
Contact Human Resources