Group #033300.  Also, as an identifer, use your social security number.

Making Changes
Changes may be made during open enrollment or within 31 days of a qualifying event by completing a Benefits Enrollment/Change Form.
Qualifying Event examples include but are not limited to marriage, divorce, birth or family member loss of coverage.

Costs
The City pays 100% of the cost of employee only coverage and employees may cover eligible family members at their own expense.

What's Covered
•    The Benefits Summary outlines what's covered by the dental plan and is also known as your Evidence of Coverage.

What Happens to My Dental Coverage If I Leave?
Under the provisions of the Consolidated Omnibus Reconciliation Act of 1985, or COBRA, you and your covered family members
may choose to continue dental coverage under the City's dental plan after your coverage is scheduled to end. You have 60 days
from the date of your COBRA election notice to elect continued coverage. If you do not respond within the 60 days, your rights
to continue coverage end. COBRA information will be mailed to your home. Be sure to keep your address current by submitting 
changes to Human Resources.

Dental Coverage at Retirement
Dental coverage eligibility in retirement is based on date of hire and years of service. To find out if you are eligible, refer to
Chapter 4, “Benefits” of the Employment Policies & Procedures Manual.

Questions?
Call Anthem Dental at 1-866-956-8607 or visit website www.anthem.com/mydentalvision, register/log in to Anthem
Dental Complete Member Services for Coverage summary, Claims inquiry, ID cards, and Dentist search.