Checklist for Employees Ending Employment

Retirement, Termination or Resignation

The following Benefit Coverages will continue ONE MONTH following your last paycheck:

State Health Benefit Plan – COBRA is available up to 18 months - Notification will be mailed from State Health Benefit Plan.

Dental & Vision – COBRA is available up to 18 months - Notification will be mailed from ShawHankins, LLC.

l  Disability – Not available for portability.

l  Life Insurance Notification will be mailed from Cigna. The policy does have portability under the following guidelines; (1) You must have continuously been insured for at least 12 consecutive months on the date your employment terminates. (2) You must be able to perform with reasonable continuity the material duties of at least one gainful occupation on the date your employment terminates. (3) You must be under age 75 on the date your employment terminates. (4) If you do not buy Life Insurance for yourself, you may not purchase any other insurance coverages.

Long Term Care does have portability. See Benefit Department for continuation paperwork.

The following Benefit Coverages will terminate on the date of your last paycheck:

l  AFLAC Cancer does have portability available – Notification will be mailed from AFLAC.

FLEX Spending Accounts – All expenses have to be incurred by the date of your last paycheck ( example: Last paycheck 7/31/2013-ending date of coverage). You will have until December 31st to file a claim for medical incurred expenses. Dependent Care incurred expense claims must be submitted within 60 days of termination date.

Tax Sheltered Retirement – Contributions to a tax sheltered retirement savings account may be eligible for roll-over to another qualified retirement account. Please contact your state retirement agency for appropriate forms. (Teacher Retirement, Public School, Valic Supplemental, Annuity Companies)

RETIREMENT – State Health Benefit Plan is the only benefit premium that can be deducted from your Retirement check. This applies to ERS, TRS, and PSERS retirees. If you or your spouse is 65 or older please contact the Benefits Department concerning your Medicare Part A & Part B.

Benefit Contacts: Janet Clack 770-887-2461 ext. 202136

Casey Hogan 770-887-2461 ext. 202139