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Plan Documents

City of Portland

Special Notice Documents

  • City of Portland Health Plan Notice Packet

  • City of Portland Health Plan Notice Packet (Spanish)

  • New Health Insurance Market Place Coverage - Options and Your Health Coverage

  • New Health Insurance Market Place Coverage - Options and Your Health Coverage (Spanish)

  • Model CHIP Notice

  • Model CHIP Notice (Spanish)

  • Model - 1095-C Notice of Availability

Transparency in Coverage Machine Readable Files

  • Meritain Machine Readable Files

RETIREMENT

  • MainePERS PLD Welcome Booklet

  • MainePERS Welcome Booklet

  • MissionSquare 401(a) Money Purchase

  • MissionSquare 401(a) Plan Highlights

  • MissionSquare Saving for Retirement Informational Brochure

  • MissionSquare - Retirement Education Center

  • Pension Comparison Chart French

  • MePERS Rates

SUPPLEMENTAL RETIREMENT SAVINGS PLAN

  • MissionSquare 5 Reasons to Consider an IRA Flyer

  • MissionSquare 457 PTS Plan Information Brochure

  • MissionSquare 457(b) Deferred Compensation Plan Information

  • MissionSquare Quick Reference Guide

  • MissionSquare Saving for Retirement Informational Brochure

LIFE INSURANCE

  • MainePERS Group Term Life Insurance Coverage Fact Sheet

DISABILITY INSURANCE

  • Unum Long Term Disability - Union for ICMA-RC 401a

  • Unum Long Term Disability - Non-Union for ICMA-RC 401a

  • MainePERS Overview of City Benefits

  • UNUM LTD Contract

  • UNUM LTD Benefits at a Glance

  • Income Protection Plan Booklet

  • Income Protection Plan Booklet - French

  • Long Term Disability (LTD) Summary

  • Short Term Disability (STD) Income Protection Plan (IPP) Summary

MEDICAL

  • Meritain Health – 2025 Benefits Presentation

  • Find a Telehealth Mental Health Provider

  • Find a Telehealth Mental Health Provider (Spanish)

  • Medical Plan Summary of Benefits (English)

  • Health Insurance Basics - English

  • Health Insurance Basics - French

  • Health Insurance Basics - Somali

  • Meritain Health - Available Discounts

  • Medical Plan – Summary of Benefits and Coverage

  • Medical Plan – Summary of Benefits and Coverage - Arabic

  • Medical Plan – Summary of Benefits and Coverage - French

  • Medical Plan – Summary of Benefits and Coverage - Lingala

  • Medical Plan – Summary of Benefits and Coverage - Portuguese

  • Medical Plan – Summary of Benefits and Coverage - Spanish

  • Medical ID Card

  • Meritain Health - Members Flyer Teladoc Extended Overview BH and Registration

  • Meritain Health - Members Flyer Meritain Portal Web Guide Extended QR

  • Meritain Health - Members Flyer OIC Online Access

  • Meritain Health - Members Flyer Coordination of Benefits

  • Meritain Health Members Flyer 2023 Surgery Benefits

  • Meritain Health - Members Flyer YouTube Videos City of Portland

  • How to Use Your Meritain Medical Portal

  • How to Use Your Meritain Medical Portal (Spanish)

  • Find a Telehealth Mental Health Provider

  • Find a Telehealth Mental Health Provider (Spanish)

  • Meritain Medical Mobile App - iPhone Instructions (English)

  • Meritain Medical Mobile App - Android Instructions (English)

  • Meritain Medical Mobile App - iPhone Instructions (Spanish)

  • Meritain Medical Mobile App - Android Instructions (Spanish)

  • MERITAIN Member-Presentation Enrollment City of Portland Maine

PHARMACY - MERITAIN & CVS CAREMARK

  • CVS Caremark Mail Order Form

  • CVS Pharmacy – 2025 Prescription Drug Changes

  • CVS Caremark – 2025 Performance Drug List

TELEHEALTH

  • Teledoc Virtual Doctors Visits

MEDICAL - FORMS

  • CVS Caremark Mail Order Form

  • COVID-19 Test Reimbursement Claim Form

  • Medical Plan – Summary of Benefits and Coverage - Portuguese

MEDICAL - COMPLIANCE NOTICES

  • Surprise Billing Notice

  • Medical Plan – Summary Plan Description

WELLNESS

  • Fitness Reimbursement Program

  • Provider Biometric Form

  • 2026 OMC Wellness Program

  • 2026 OMC Wellness Program (French)

  • 2026 OMC Wellness Program (Spanish)

  • 2026 OMC Wellness Program (Portuguese)

  • City of Portland QR Code Flyer

  • City of Portland QR Code Flyer (French)

  • City of Portland QR Code Flyer (Portuguese)

  • City of Portland QR Code Flyer (Spanish)

FSA

  • Navia - Claim Form

  • Navia - Claim Submission Tools

  • Navia - Enrollment Kit

  • FSA Summary Plan Description

  • MyNavia - App Registration Guide

  • Navia - Participant Online Registration Instructions

  • Navia Worksheet - Health and Day Care FSA Expense Estimation

DENTAL

  • Delta Dental – 2025 Benefits presentation

  • Delta Dental - Carryover Benefit

  • Delta Dental - Claim Form

  • Delta Dental - Terms You Should Know - French

  • Delta Dental - Terms You Should Know - Somali

  • Delta Dental - Terms You Should Know

  • Delta Dental - Nondiscrimination Notice

  • HOW Patient and Provider Instructions

  • HOW FAQs

  • HOW Summary of Enhanced Benefits

  • Mobile App Flyer

  • Delta Dental – High Plan Summary (French)

  • Delta Dental – High Plan Summary (Portuguese)

  • Delta Dental – High Plan Summary (Spanish)

  • Delta Dental – Low Plan Summary (French)

  • Delta Dental – Low Plan Summary (Portuguese)

  • Delta Dental – Low Plan Summary (Spanish)

Vision

  • Aetna Vision – 2025 Benefits Presentation

  • Aetna Voluntary Vision - Benefit Summary

  • Aetna Voluntary Vision Out of Network Claim Form (English)

  • Aetna Voluntary Vision Out of Network Claim Form (Spanish)

SUPPLEMENTAL HEALTH

  • Cigna Healthcare – 2025 Supplemental Insurance Presentation

  • Cigna- Healthcare Supplemental Health Solutions Limitations and Exclusions

  • Cigna - Accidental Injury Insurance

  • Cigna - Critical Injury Insurance

  • Cigna Supplemental Health – CI Wellness Benefit

  • Cigna - Hospital Care Insurance

  • Cigna – How to File a Claim

  • Cigna - How to File a Claim (Arabic)

  • Cigna - How to File a Claim (Chinese)

  • Cigna - How to File a Claim (Croatian)

  • Cigna - How to File a Claim (French)

  • Cigna - How to File a Claim (Haitian Creole)

  • Cigna - How to File a Claim (Portuguese)

  • Cigna - How to File a Claim (Somali)

  • Cigna - How to File a Claim (Spanish)

Critical illness

  • Cigna Benefit Summary - Critical Illness Insurance

  • Cigna Supplemental Health – CI Wellness Benefit

  • Cigna Benefit Summary - Critical Illness Insurance - Arabic

  • Cigna Benefit Summary - Critical Illness Insurance - Croatian

  • Cigna Benefit Summary - Critical Illness Insurance - French

  • Cigna Benefit Summary - Critical Illness Insurance - Hatian Creole

  • Cigna Benefit Summary - Critical Illness Insurance - Lingala

  • Cigna Benefit Summary - Critical Illness Insurance - Portuguese

  • Cigna Benefit Summary - Critical Illness Insurance - Somali

  • Cigna Benefit Summary - Critical Illness Insurance - Spanish

  • Cigna Benefit Summary - Critical Illness Insurance - Traditional Chinese

Accident Insurance

  • Cigna Benefit Summary - Accident Insurance

  • Cigna Benefit Summary - Accident Insurance - Arabic

  • Cigna Benefit Summary - Accident Insurance - Croatian

  • Cigna Benefit Summary - Accident Insurance - French

  • Cigna Benefit Summary - Accident Insurance - Hatian Creole

  • Cigna Benefit Summary - Accident Insurance - Lingala

  • Cigna Benefit Summary - Accident Insurance - Portuguese

  • Cigna Benefit Summary - Accident Insurance - Somali

  • Cigna Benefit Summary - Accident Insurance - Spanish

  • Cigna Benefit Summary - Accident Insurance - Traditional Chinese

Hospital Care Insurance

  • Cigna Benefit Summary - Hospital Care Insurance

  • Cigna Benefit Summary - Hospital Care Insurance - Arabic

  • Cigna Benefit Summary - Hospital Care Insurance - Croatian

  • Cigna Benefit Summary - Hospital Care Insurance - French

  • Cigna Benefit Summary - Hospital Care Insurance - Hatian Creole

  • Cigna Benefit Summary - Hospital Care Insurance - Lingala

  • Cigna Benefit Summary - Hospital Care Insurance - Portuguese

  • Cigna Benefit Summary - Hospital Care Insurance - Somali

  • Cigna Benefit Summary - Hospital Care Insurance - Spanish

  • Cigna Benefit Summary - Hospital Care Insurance - Traditional Chinese

PROFESSIONAL DEVELOPMENT

  • 50% Tuition Discount on USM Undergrad and Grad Degree Classes

  • Thomas College Overview

  • Community College Scholarships

  • Thomas College Discount Form