Insurance

2019/2020 Open Enrollment

Health Plan Documents and Guides

  1. 2019.2020 YCT Enrollment Benefit Guide Interactive
  2. 2019.2020 Benefits Election Form - Fillable
  3. 2019.2020 YCT Whats New
  4. 2019.2020 Town of Chino Valley Benefits Summary
  5. YCT 2019 SBC for the Premier Plan
  6. YCT 2019 SBC for Basic Plus Plan
  7. YCT 2019 SBC for the HDHP
  8. Teladoc Consulting Overview
  9. 2019.2020 Flexible Spending Account Election Form
  10. OptumRxSelectStandard
  11. JBG Cares - Town of Chino Valley EAP
  12. YCT CHIP Notice
  13. YCT Exchange Notice - Town of Chino Valley

2018/2019 Benefit Videos


Health Insurance Forms

  1. Mid Year Enrollment Changes Allowed Under YCT Plan
  2. Medical and Dependent Care Reimbursement Form

Health Savings Account

A High Deductible Health Plan (HDHP) along with a Health Savings Account (HSA) can give you more flexibility and control of your health care dollars before taxes and save you even on your taxes.  This plan will provide the preventative wellness benefits that you are used to.  With the HSA you have the opportunity to build your balance from year to year for use into your retirement.  Get more information by accessing the following documents:

  1. HSA Health Equity Brochure
  2. HSA FAQs
  3. HSA Employee Enrollment Form
  4. Employee HSA Payroll Deduction Form

Life Insurance

  1. Securion Lifestyle Benefits Flyer
  2. Securion Initial Life Insurance Enrollment Packet - YCT Town of Chino Valley
  3. Securion Life Insurance Enrollment Worksheet
  4. Securion Life Insurance Evidence of Insurability Form
  5. Securian Conversion - AZ
  6. Securian Employee Group Term Life Certificate of Insurance

ICMA-RC (Forms)

  1. 457 ContributionChangeForm2019
  2. 457 Loan Refinance Application Form (PDF)