Check(3) Information to Consider:

q Review your current benefit elections.

To review these online, visit bcbsok.com. Log in to Blue Access for MembersSM, then select the My Coverage tab and click Benefits Highlights.

q Be sure to check your covered dependents and confirm that they meet the dependent eligibility criteria.

To view dependent information within Blue Access for Members, select the My Coverage tab and click Coverage Details.

q Review the open enrollment brochure Review the open enrollment brochure

q Confirm that your doctor is a contracted network provider for the plan that you are considering.

To search for your health care providers, go to bcbsok.com. Click Members, then Provider Finder, and search by name or location.

q Consider whether you want to add or change any of your benefit options (for example, health or dental).

q When choosing your health or dental plans, consider the plan differences below: • Contribution rates • Covered benefits • Copayments and deductibles • Networks • Whether referrals are necessary

q Once you have completed all of the necessary enrollments or changes, submit the forms to:

q Review your benefit selections by calling.

If you need to make corrections, contact Human Resources immediately. Corrections will not be accepted after.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 72842.0612

The open enrollment checklist is provided as a general guide to assist you as you make benefit enrollment decisions for you and your dependents. It is not intended as a comprehensive list of everything needed to complete open enrollment.

Open Enrollment Checklist