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2015-2016 Benefits Guide

20

Following is a link to the latest form and states where you may be eligible for assistance paying your employ-

er health premiums:

http://www.dol.gov/ebsa/pdf/chipmodelnotice.pdf

For more information on special enrollment rights, you can contact either:

U.S. Department of Labor

U.S. Department of Health and Human Services

Employee Benefits Security Administration

Centers for Medicare and Medicaid Services

www.dol.gov/ebsa www.cms.hhs.gov

1-866-444-3272

1-877-267-2323

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