If you are a member, or planning to become a member, we recommend reading any disclosure that's applicable to you so that you can become more familiar with your plan regarding state-specific mandates. Simply locate the state and click on the applicable disclosure. If you are considering becoming a member and have questions about your plan coverage, please contact your benefits administrator.

While reviewing the information on this page, it's important to note:

• States without disclosures won't be shown.
• Certain mandates may only apply to certain plan types (i.e., HMO). All state mandates will include a plan type, so choose accordingly.
• State mandates may not apply to self-funded plans. Please contact your benefits administrator if you need to know whether your plan is self-funded or not.

California

• CA HMO Comparative Benefit Matrices, Rates and Health Plan Websites

Colorado

• HMO disclosure also available in Spanish

Florida

• Florida HealthStat

HRA PPO Plan

HRA coverage can only be chosen together with the HRA PPO Plan option. Your HRA coverage is self-funded by your employer, who is solely responsible for contributing the funds used to pay HRA benefits. You are not required to make any contribution to the HRA account, either pursuant to a salary deduction election or otherwise under a Section 125 cafeteria plan (except that contributions are required from those under COBRA continuation coverage). You may not enroll under this option if you are considered self-employed (including partners and more-than-2% shareholders in a subchapter S corporation).

HSA Pre-enrollment Statements

WARNING: You cannot open an HSA if, in addition to coverage under an HSA-qualified High Deductible Health Plan ("HDHP"), you are also covered under a Health FSA or an HRA or any other health coverage that is not an HDHP.

If you checked the HDHP-HSA box on your Medical Enrollment Form, you expressed your interest in opening a Health Savings Account (HSA) with Mellon Trust of New England, N.A., an HSA service provider arranged by Great-West Healthcare ("Great-West") or any other successor HSA service provider arranged by Great-West (hereafter "the HSA Service Provider"). The HSA Service Provider will contact you and provide you with an HSA enrollment form, a signature card, a request for information for a Customer Identification Program compliance and other related materials necessary to open an HSA account with the HSA Service Provider.

In order to open an HSA with the HSA Service Provider, you must: 1) in a timely manner, complete, sign and submit all the forms required by the HSA Service Provider; and 2) be found to meet all of the requirements prescribed by the HSA Service Provider.

However, if your employer has not selected Mellon Trust of New England, N.A. as the HSA service provider, you may open the HSA with an HSA custodian/trustee that is either arranged by your employer or that you personally select. You must agree to complete necessary forms and meet the requirements set forth by the HSA custodian/trustee pertaining to the establishment and operation of your HSA.

With respect to an HSA opened pursuant to this arrangement, the HSA trustee/custodian will be solely responsible for all HSA services, transactions and activities related thereto. Neither your employer nor Great-West is responsible for any aspects of the HSA services, administration and operation.

Prior to enrollment, you must certify that you have enrolled or plan to enroll under an HDHP and are not covered under any other health coverage that is not an HDHP.