BENEFITS & RETIREMENT

MRI, CT, X-RAY, Preventative Body Scan & Virtual Colonoscopy

HealthCheck Radiology 100% Covered

• Virtual Colonoscopy (PDF)
• Health Check Radiology Program (PDF)
• Body Scan Benefit (PDF)

Connect Benefits

100% Covered Primary Care, Urgent Care and Emergency Room Care

• Connect Benefit Medical ID Card
• Primary, Urgent and ER Care

100% Covered Referral Service – Surgery, Heart Care, Specialty Care, ER, Urgent Care, Cancer Care, Maternity and MUCH MORE!

• Connect Benefit 100% OK County Brochure
• Text Servicing Flyer
• Nurse Navigator Team

For most services under Connect Benefit, you must first call or email to obtain a pass and referral for services.
For primary care, urgent care and emergency services, no pass is needed.  Just show your connect benefit card at the time of service. 

Counseling, Brain Care, Wellness and Primary Care Clinics

Rivus and AIM Clinics 100% Covered

• Aim Clinic 100% Covered Primary Care and Family Care
• Aim Health Move to Shepard Center
• Rivus Information Sheet (PDF)

Quest Select

100% Covered Lab and Pathology Benefit

• Quest Select

Colonial Life Forms

• Colonial Term Life Brochure (PDF)
• Colonial Medical Bridge Plan 5 Brochure (PDF)
• Colonial Disability Brochure (PDF)
• Colonial Critical Illness Brochure (PDF)
• Colonial Cancer Brochure (PDF)
• Colonial Accident 1.0 Premier Brochure (PDF)

Dental Insurance

• Delta Dental Benefits (PDF)

Discounted Gym Membership

• Discounted Gym Membership (PDF)
• See YMCA section below

Employee Assistance Program

• Live Well Services (PDF)
• Deer Oaks EAP (PDF)
• Coach Overview (PDF)
• iConnectYou Flyer - Oklahoma County (PDF)

Flexible Spending Plan (FSA)

• OC Flex Document (PDF)
• FSA Amendment (PDF)
• HealthCare Reimbursement Claim Form
• 2024 FSA DCA Open Enrollment Guide - With Debit Card
• Dependent Care Claim Form
• 2024 FSA-DCA-Enrollment Form-Non-Fillable

Health Plan

• 2024 OK County Annual Enrollment Guide
• 2024 Summary of Benefits and Coverage for OK County
• OK County Health Plan (PDF)
• Health Plan Dialysis Amendment
• Health Smart Enrollment (PDF)
• Health Smart Service Request Form (PDF)
• Health Smart Web eXchange Member Center
• MAA Health Benefits Submission Form (PDF)
• MAA Accident Injury Questionnaire Form (PDF)
• MAA Annual Data Form (PDF)
• Uniform Glossary of Health Coverage and Medical Terms (PDF)
• Amendment 4 Effective 3-16-2020
• Amendment 5 Effective 4-2-2020

Hearing Aid Discount Program

• VSP Hearing Aid Discount Program (PDF)

Legal & Credit Shield

• Legal Shield Information (PDF)
• Legal Shield Enrollment Form (PDF)
• Legal Shield Gun Owner Policy (PDF)
• Legal Shield Rates & Contact Info (PDF)

Liberty Mutual Auto / Home Insurance

• Auto and Home Insurance Contact Information (PDF)

Long Term Care

• Long Term Care

Mutual of Omaha

• Term Life Certificate Summary (PDF)
• Term Life Certificate (PDF)
• STD Claim Form (PDF)
• STD Certificate Summary (PDF)
• Portability Form (PDF)
• LTD Claim Form (PDF)
• LTD Certificate Summary (PDF)
• Life Conversion Form (PDF)

Premise Health Clinic

• My PH Phone Brochure
• Premise Health Locations and Information

Retirement

• ANNOUNCEMENT Retirement Plans are Now Live
• 401(a) Defined Contribution Plan
• OK County Life and AD&D Policy (PDF)
• Beneficiary Designation Form  |  457 Beneficiary Designation Form
• Beneficiary Change Form  |  457 Beneficiary Change Form
• Death Benefits Application  |  457 Death Benefits Application
• Direct Deposit Form  |  457 Direct Deposit Form
• Inservice Unforseeable Emergency Withdrawal Form
• MASTER - Employee Defined Contribution System  |  457 MASTER - Employee Defined Contribution System
• Plan Highlights  |  457 Plan Highlights
• QDRO Form  |  457 QDRO Form
• RMD Form  |  457 RMD Form
• 457 Rollover Contribution Form
• SDO Form  |  457 SDO Form
• Special Tax Election Form
• Standard Enrollment Form  |  457 Standard Enrollment Form
• 457(b) Deferred Compensation Plan
• StartRight New User Log On Guide
• Termination Packet  |  457 Termination Packet
• Retirement Provision Amendment Rule

RX Plan

• AffirmedRx Patient Care Advocates
• AffirmedRx Welcome Notice
• Employee Prescription Program

Vision Benefits

• Vision Benefits Summary (PDF)
• Out Of Network Reimbursement Form (PDF)

YMCA

• OK County YMCA Membership
• OK County YMCA Application
• YMCA Member Change Form