Active Police Benefits
Completed benefits forms, along with any supporting dependent documentation, can be sent to the Benefits Office via:
Scan and email to benefits@providenceri.gov
Fax to 401-680-5457
Mail to Benefits Office, 25 Dorrance Street, Room 411, Providence, RI 02903
If you have additional questions, please reach out to the Benefits Office via an email to benefits@providenceri.gov or phone 401-680-5279.
We will do our best to get back to you as soon as we can.
QUALIFYING EVENT
A life event that allows you to make changes to your current health plan
- Qualifying Events include: Marriage/Birth/Adoption/Loss of coverage
- Documentation: Marriage License/Birth Certificate/Adoption papers/ HIPAA letter
*ALL CHANGES MUST BE SUBMITTED WITHIN 30 DAYS OF THE QUALIFYING EVENT WITH THE PROPER DOCUMENTATION
NEW THIS YEAR
OPEN ENROLLMENT IS NOW THE MONTH OF MAY
OPEN ENROLLMENT
Open Enrollment occurs annually in May and allows you to alter your current health elections for a July 1 effective date.
Core Benefits
Benefits at a Glance
Benefits Enrollment Form
MEDICAL BENEFITS
Provided by Blue Cross Blue Shield of Rhode Island
Local – (401) 459-5000
Out of state residents – 1-800-369-2227
Website: www.bcbsri.com
THE UNIFORM SUMMARY OF BENEFITS AND COVERAGE (SBC) IS A LEGALLY REQUIRED HEALTH PLAN DISCLOSURE DOCUMENT
BLUE CROSS SUMMARIES
Medical Policy: Gender Reassignment Surgery
DENTAL BENEFITS
Provided by Delta Dental of RI
Billing – (401) 752-6200
Enrollment – (401) 752-6234
Customer Service – (401) 752-6100
Website: www.deltadentalri.com
DELTA DENTAL SUMMARIES
Police Union Delta Dental Co-Max Flyer
Police Non-Union Delta Dental Co-Max Flyer
PRESCRIPTION BENEFITS
Provided by CVS Caremark
Customer Service: 1-888-790-8070
Website: www.caremark.com
CVS CAREMARK SUMMARIES
VISION BENEFITS
Provided by Blue Cross Blue Shield of RI
Police Union
- One annual routine eye exam per the calendar year with co-payment under the medical policy
- One annual routine eye exam per the calendar year with co-payment under the medical policy
- Prescription glasses (lenses and or frames) or contact lenses are covered up to a maximum of $100 per -calendar year. Members pay the full charge whether using a participating or non-participating provider and files claim to BCBSRI for reimbursement
Voluntary Benefits
VISION BENEFIT
Provided by Davis Vision
Website: https://davisvision.com/members/
A comprehensive benefit ensuring low out-of-pocket cost to members and their families. Convenient Network Locations consisting of a national network of credentialed preferred providers throughout the 50 states.
Freedom of Choice, you will have access to care through either Davis Vision network of independent, private practice doctors or select retail partners. Value-Added Features includes mail order contact lenses replacement contacts (after initial benefit) through DavisVisionContacts.com. Mail order service ensures easy, convenient, purchasing online and quick, direct shipping to your door. Also, Laser Vision Correction discounts of up to 25% off the provider’s Usual and Customary fees or 5% off advertised specials, whichever is lower.
Out-of-Network Benefits
You may receive services from an out-of-network provider, although you will receive the greatest value and maximize your benefit dollars if you select a provider who participates in the network. If you choose an out-of-network provider, you must pay the provider directly for all charges and then submit a claim for reimbursement.
Davis Vision Reimbursement Form
OPTIONAL LIFE INSURANCE
Available to Police, Fire, School and Non-Union employees
Administered by Prudential
Website: https://mybenefits.prudential.com
Optional Life Insurance may be elected as a new hire or during Open Enrollment at the employee’s cost (cost is based upon employee’s age and coverage amount requested). An Evidence of Insurability Form will need to be completed if electing more than $200,000 in optional life insurance.
Prudential Group Insurance Beneficiary Designation-Change
Prudential Optional Life Rates
Portability/Conversion at Termination
You may be eligible to port or convert your basic and your optional life coverage(s). To be eligible to port coverage, you must have been actively at work on the date employment ended and not retiring. You must complete an application and apply for these options within 31 days of your coverage termination. To obtain an application, please contact Prudential at 1-800-778-3827. Please provide the contract number – 54180 when calling. If you are using a telecommunications device for the hearing impaired (TDD), please call 1-800-496-1214. Representatives are available to assist you Monday through Friday between 8:00 AM and 8:00 PM Eastern Time.
FLEXIBLE SPENDING ACCOUNT (FSA)
Healthcare, Dependent Daycare and Transit – Flexible Spending Account – administered by London Health Administrators. in partnership with Blue Cross and Blue Shield of Rhode Island.
FSA claims for 2021-2022. Extended Grace period through June 30, 2022 to use current year contributions.
IDENTITY AND PRIVACY PROTECTION PLAN FOR ALL EMPLOYEES AND THEIR FAMILIES
Administered by Allstate Identity Protection (InfoArmor)
Website: https://www.infoarmor.com/
InfoArmor is protection that includes 24/7 high-risk activity monitoring and will provide assistance with recovering and restoring your identity should theft or fraud occur! Your identity is made up of more than your Social Security number and credit score. Allstate will also help you look after your online activity, from financial transactions to what you share on social media – so you can protect the trail of data you leave behind.
- Identity monitoring and alters
- Full-service remediation
- Identity theft reimbursement
- iOS and Android app
FLU SHOTS
Employees and retirees can receive the flu vaccine at a local pharmacy by presenting their CVS Caremark Card or Blue Cross Blue Shield Card.
COORDINATION OF BENEFITS
Active Coordination of Benefits Form
Applies to spouses/qualified ex-spouses of active employees who have access to health coverage through his/her employer. Working spouses/ex-spouses must enroll in an individual plan with his/her employer. You as the employee will be reimbursed in your bi-weekly paycheck the cost that your spouse gets deducted out of his/her paycheck.
- Your spouse/ex-spouse remains enrolled in full coverage with the City.
- Your spouse/ex-spouse is enrolled in his/her employer’s plan as primary and the City’s plan as secondary.
- You are reimbursed for the cost of the plan (co-share) that your spouse/ex-spouse pays out of his/her paycheck.
- Whatever the spouse’s/ex-spouse’s employer ‘s plan does not cover, the City’s plan covers.
- If the only plan available to a working spouse is an HSA, the spouse does not need to enroll(proof/documentation required)
- Proof and cost of coverage required - see FAQ for details