Benefit Information

Contact Information:
Employee Benefits Corporation
Customer Service: 1.800.346.2126
Website address: HERE

Flexible Spending Forms:

• Flexible Spending Claim Form
• Flexible Spending Direct Deposit Form
• Flexible Spending Eligible Expenses
• Flexible Spending Summary Plan Description
• Flexible Spending Enrollment Guide
• Flexible Spending My Company Plan

Contact Information:
Customer Service Group Life Claims: 1.888.563.1124
Customer Service Voluntary Life Insurance Conversions and Portability: 1.877.320.0484
Website: HERE
 

Company Life Insurance Forms:

• Life Insurance Summary

Voluntary Life Insurance Forms:

• Voluntary Life Insurance Rates

Contact Information:
Customer Service: 1.888-277.4767
Website: HERE
 

LTD Insurance Forms:

• LTD Summary Leadership Employees
• LTD Summary Exempt and Fulltime Employees

Employee discounts are provided to staff members as a benefit of their employment and are listed on the Employee Discount Schedule

EMPLOYEE DISCOUNT SCHEDULE

ABILITY ASSIST COUNSELING SERVICES

Prairie States:

Create an account and log in to print your ID card.
You can also call 1-800-615-7020 and ask for a new card to be sent to you.

PRAIRIE STATES LOG IN

Delta Dental: 

How can I access my ID card?
Sign in to your online account to download or email your ID card from your dashboard.
You can also call their Customer Experience Specialists at 1.800.236.3712 to assist you.

DELTA DENTAL LOG IN

Superior Vision:

Create an account and login to print your ID card.
You can also call 1-800-507-3800 and ask for a new card to be sent to you.

SUPERIOR VISION LOG IN

• Important COBRA Updates 2021 Due to the National Emergency and the COVID-19 Pandemic
• Annual Notice
• Health Insurance Plan Document
• Employee Welfare Benefit Plan Wrap-Around Summary Plan Description
• SPD For YMCA of the Fox Cities Employee Welfare Benefit Plan 2021
• Creditable Coverage Disclosure Notice
• Notice of Privacy Practices
• Transplant Federal Notice
• Transplant Certificate of Coverage
• Section 125 Plan Document
• 2021 Summary Annual Report for YMCA of the Fox Cities Employee Benefit Plans
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 1
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 2
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 3
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 4
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 5
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 6
• YMCA of the Fox Cities Employee Welfare Benefit Plan Amendment 7

The federal Transparency in Coverage rules require health plan sponsors to provide pricing disclosures via separate sets of machine-readable files (MRFs) posted on a public website. The intent of this aspect of the federal transparency rules is to make public the financial arrangements in place between health plans and providers. These MRFs are not for participant use, but rather the files are designed to be read by a computer system and are intended to be available for researchers and policy makers to have access to health plan costs nationally on an aggregate basis.

Prairie States Enterprises, Inc. is an independent third party administrator of a self-funded health plan for YMCA of the Fox Cities.  

The YMCA of the Fox Cities, who is the plan sponsor, has contracts with local, regional, and national Preferred Provider Organizations (PPOs) for negotiated rates with hospitals, doctors, and clinics.  Prairie States has created a portal as a service to plan sponsors and PPOs, to host the machine readable files that plans are required to publicly provide to facilitate the transparency in coverage rule as mandated by federal law.  Please click the link below to go to the portal:

https://www.prairieontheweb.com/Employers/transparency.php