5 Health Options – Blue Cross Blue Shield HMO, United Healthcare HMO, United Healthcare PPO w/Heath Reimbursement Account, United Healthcare PPO and Blue Cross Blue Shield PPO. Single, Couple or Family coverage is available. CPS shares in cost of coverage.

2 Plans – PPO and Dental HMO(DHMO). Single, Couple or Family coverage. Insured by Delta Dental. CPS shares in cost of coverage.

If you are enrolled in a CPS medical option, CPS provides you and your eligible family members with the Basic Vision Plan administered by Vision Service Plan (VSP). You do not pay a premium for this coverage. When you use VSP network providers you receive an annual eye exam covered in full with a $15.00 co-pay. In addition to eye exams, you will get discounts on eyewear.

You can upgrade your Basic Vision Plan for a monthly premium and receive coverage for glasses, contacts and discounts on laser vision correction.

Medical Reimbursement Account maximum annual contribution $3,000. Dependent Care Account maximum annual contribution $5,000. Employee contributions only.

$25,000 death benefit. Insured through Prudential Insurance Company. CPS pays premium.

Income protection program available through payroll deductions. 90 Day or 180 Day Options. Proof of good health not required if enrollment occurs upon hire. Insured through Prudential Insurance Company. Employee pays premium.

Employee Coverage of 1-4 times annual salary. Coverage available for eligible spouse and dependents. Proof of good health not required for up to 3 times annual salary, if enrollment occurs upon hire. Insured through Prudential Insurance Company. Employee pays premium.

Employee coverage of 1-4 times annual salary. Coverage available for eligible spouse and dependents. Must match enrollment in Optional Life Plan. Insured through Prudential Insurance Company. Employee pays premium.

Comprehensive personal financial analysis to determine net worth and strategies to reach short and long-term goals. Coverage available for eligible spouse and dependents. Services provided by PricewaterhouseCoopers. Employee pays premium.

Legal services program with access telephone network attorney, in-office network attorney, non-network attorney or online information. Coverage available for eligible spouse and dependents. Network provided through ARAG Group. Employee pays premium.

403(b)/457 payroll deductions up to $31,000 per year through AIG VALIC, CitiStreet, Hartford, Horace Mann, ING, and MetLife. Employee contributions only.

Online Enrollment Instructions

Investment program to save for a child’s college-related expenses. Sponsored by State of Illinois (Oppenheimer Funds). After-tax payroll deductions up to $220,000 maximum for each covered child. Employee contributions only.

• An Original Certified Birth Certificate

• An Original Certified Birth Certificate

AND

• Student Status or Tax Dependency Documentation: If your child is a full-time student in:

   

  • High school, provide a statement from the school clerk or principal verifying that the child is a student.
  • An accredited college or university, provide a letter from the registrar’s office, a student schedule on letterhead documenting enrollment for the current term with 12 or more credit hours or a tuition statement. This documentation will be requested on an annual basis.
  • If your child is a tax dependent, the notarized affidavit “Affidavit to Establish Dependency” is needed to satisfy eligibility requirements. This documentation will be requested on an annual basis.
  • If your dependent is disabled, you must submit a Dependent Disability Certification Form.

• If the child is your adopted child and the birth certificate has not yet been amended to name you and other adoptive parent as the child’s parents, then the letter issued by the governmental agency placing the child in your home will suffice for documentation, until such reasonable time as the amended birth certificate can be issued.

• You do not need to prove your relationship as the child’s parents if you are the child’s legal guardian. You must provide a copy of the Guardianship Appointment certified by the Clerk of the Court in which the appointment occurred.

• An Original Certified Marriage Certificate

• Proof of domestic partnership is required. To determine if your partner qualifies for enrollment, the following eligibility requirements must be met:

   

  • First you, the employee, must be enrolled in a CPS sponsored medical or dental plan;
  • You must submit a completed Affidavit of Domestic Partnership and meet the eligibility requirement for a Domestic Partner.
  • You must submit Certified Birth Certificates and copies of your Illinois Driver’s Licenses or State of Illinois Identification Cards for both you and your partner.

   

• The Benefits Employee Services Team will review your affidavit to determine if you meet the minimum requirements listed below:

   

  • You and your partner are each other’s sole domestic partner, responsible for each other’s common welfare;
  • Neither you nor your partner are married (if you or your partner were previously married, proof of Dissolution of Marriage is required);
  • You and your partner are not related by blood closer than would bar marriage in the State of Illinois;
  • You and your partner are at least 18 years of age, are the same sex and reside at the same residence;

AND

• At least two of the following four conditions must apply:

   

  • You and your partner have been residing together for at least twelve (12) months prior to filing the Affidavit of Domestic Partnership;
  • You and your partner have common or joint ownership of a residence;
  • You and your partner have at least two of the following arrangements:
    • Joint ownership of a motor vehicle;
    • A joint credit account;
    • A joint checking account;
    • A lease for residence identifying both you and your partner as tenants.
  • You declare your partner as a primary beneficiary in your will.