Employee Benefits

The City of Fort Dodge offers a wide variety of benefits to employees to include vacation, sick, and holiday pay, medical and dental insurance, life insurance, retirement insurance, and more!

Health Insurance

WellmarkEBSEBS

Wellmark Blue Cross and Blue Shield (Register online for access to a variety of healthcare tools and information!)

Wellmark Member COVID-19 Update (Important health insurance benefit adjustments have been made to help ensure the well-being of our members and their families during the COVID-19 pandemic. Click on the link above for more details.)

Summary of FY21 Health Insurance Plans

Please remember with the IGHCP partial self funding arrangement insurance claims will first process through Wellmark and then through EBS to our lower plan limits.   

Summary Plan Description (SPD)

IGHCP Plan A (HDHP) Summary of Benefits & Coverage

City Plan A (HDHP) Summary of Benefits & Coverage

IGHCP Plan B Summary of Benefits & Coverage

City Plan B Summary of Benefits & Coverage

IGHCP Plan A (HDHP) Coverage Manual

IGHCP Plan B Coverage Manual

For a list of all drugs covered under the plan, please view the Blue Rx Value Plus Formulary.

Click HERE for a list of drugs that require prior authorization.

Drugs not included in this list shall be considered non-formulary and are NOT COVERED. In some instances, Wellmark will consider coverage exceptions. Coverage of non-formulary drugs may be requested by the health professional through an exception request for a non-formulary prescription drug. Generally, the following guidelines must be documented in order for an exception to be granted:

  • All covered formulary drugs on any tier will be ineffective; OR
  • All covered formulary drugs on any tier have been ineffective; OR
  • All covered formulary drugs on any tier would not be as effective as the non-formulary drug; OR
  • All covered formulary drugs would have adverse effects

Health Insurance 101: Where do my premium dollars go?

How to pull your "Year-to-Date Spend" report

How to pull your wellness benefit information

EBS Gateway Claims Portal - Easy steps for online access!

Flexible Spending Accounts

WageWorks

Flexible Spending Account (FSA) Enrollment Guide

FSA Flyer

FSA Enrollment Form

FSA HealthCare Account Pay Me Back Claim Form

FSA DependentCare Pay Me Back Claim Form

FSA Eligible Expenses

Health Saving Accounts

Two Rivers

HSA Election Change Form

Changes to your HSA must be received by 5:00 pm on the last Monday of March, June, September or December to be effective for the following quarter.

Please contact Two Rivers Bank directly for changes to anything other than elections. You can call them at (888) 226-6063 between 8am – 5pm CST Monday thru Friday, and 8:30am – 12noon CST on Saturday; chat securely with them online from 8am – 5pm Monday thru Friday or 9am-noon on Saturday; or via secure messaging by logging into your Two Rivers Bank online account, selecting support and choosing the appropriate form to submit or create a support request.

Zelis Payment Enrollment Instructions

HSA Eligible Expenses

IRS Publication 502 Eligible Expenses

Changes to HSA Eligible Expenses under the CARES Act

Dental Insurance

Delta Dental

Delta Dental COVID-19 Update 3/23/2020

Find a Provider

Delta Dental of Iowa Manual 

Delta Dental Benefits Summary

Delta Dental Change Form

Vision Care Discount Program

Vision Insurance *100% Voluntary*

Avesis Vision

Find a Provider

Avesis Vision Benefits Summary

Avesis Vision Change Form

Life Insurance

The Hartford

The Hartford Life and Accident Insurance Coverage Summary

The Hartford Benefit Highlight Sheet - Class 1

The Hartford Benefit Highlight Sheet - Class 2

The Hartford Benefit Highlight Sheet - Class 3

The Hartford Beneficiary Designation Form

The Hartford Safe Haven Program

Retirement

ICMARC

457 Deferred Compensation Plan Employee Enrollment Form

457 Contribution Change Form

IRA Account Form

Vantagecare Retirement Health Savings Plan Enrollment Form

Vantagecare Retirement Health Savings Plan Reimbursement Form

IPERS

Iowa Public Employees' Retirement System (IPERS)

IPERS Contribution Rates

Understanding IPERS

IPERS Enrollment/Beneficiary Change Form

MFPRSI

Municipal Fire and Police Retirement System of Iowa (MFPRSI)

MFPRSI Contribution Rates

MFPRSI Name/Address Change Form

MFPRSI Beneficiary Form

my Social Security

My Social Security Benefits

Employee Assistance Program

EFR

Benefit Summary

Miscellaneous

Provider Flyer

MyIDCare Services

Wellmark Calls

Healthcare While Traveling






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