SAIC Benefits Information and Forms
Commonly used SAIC benefit claim forms may be downloaded from this site by SAIC employees and their family members.
Summary Plan Description Web Site
The SAIC Benefits Summary Plan Descriptions web site is designed to provide employees and their families with important information about available benefit plans, including:
Life Events Guide
These charts describe benefits and options that may be available when experiencing a major life event like getting married, having a new child or becoming disabled.Participating in the Plans
This section provides information on eligibility, coverage, cost of coverage and enrollment.Medical Plans
SAIC offers eligible employees comprehensive medical coverage through several preferred provider organization (PPO) plans.Dental Plans
SAIC offers different types of dental plan options.
Vision Plans
Participants may elect coverage for themselves and their families under a vision plan.Flexible Spending Accounts
Save money by paying for eligible health care and/or dependent day care expenses on a pre-tax basis.Life and Accidental Death and Dismemberment (AD&D Insurance)
SAIC offers several types of financial protection for participants and their families if they were to die or be injured in an accident.Disability Programs
This program is designed to provide income in the event a participant becomes ill or disabled and is unable to work for an extended period of time.
About Benefit Election Changes
Benefits elections are made by employees at the time of hire (or as they become eligible), and during the annual Open Enrollment period.
Employees can make changes to benefits for the current benefit plan year (outside of Open Enrollment) such as to add or drop a dependent if they have experienced a qualified life event change. Employees should contact the Shared Services Center HR at 866-955-SAIC (7242), option 2 or sschrbsd@saic.com and a benefits specialist will explain the process based on what change is required.
Please note, Internal Revenue Service (IRS) regulations require that enrollment elections must remain in effect for the entire plan year unless you experience a qualified life event change.
You have 31 days from the date of a life event change to modify your elections without waiting until the next Open Enrollment period.
Download Benefits Claim Forms
Commonly used SAIC benefit claim forms may be downloaded from this site by SAIC employees and their family members.
Please note, the insured employee must sign all forms before they are submitted.
Questions about plan benefits should be directed to the plan provider (see web site links provided below), or the SAIC the Shared Services Center HR at 866-955-SAIC (7242), option 2 or sschrbsd@saic.com and a benefits specialist will be able to assist you.
If you are an employee with access to ISSAIC, the SAIC Intranet, a complete selection of benefits forms is available via the online Forms Library.
For contact information on retirement plans and access to Vanguard, please see our contact information matrix.
We want to hear from you. Please send your comments or suggestions for future additions to this page.
Medical
Use this form to file claims for medical benefits for the SAIC Self-Insured Plans ONLY (MedPlus, MedBasic, Catastrophic, and Out-of-Area). If you are enrolled in one of the SAIC self insured plans and live in AR, CA, DC, DE, IA, ID, IL, KS, MD, ME, MI, MN, MO, MT, ND,NE, NH, NJ, NV, NY, OK, OR, PA, SD, VA, VT, WI, WV, WY you will use the Aetna Medical claim form:
For contact or claims information, visit the Aetna web site http://www.aetna.com
If you are enrolled in one of the self insured plans and live in AK, AL, AZ, CO, CT, FL, GA, IN, KY, LA, MA, MS, NM, NC, OH, PR, RI, SC, TN, TX, UT, WA you will use the Anthem Blue Cross Claim form:
For contact or claims information, visit the Anthem web site http://www.anthem.com/saic/
HMO plans do not use a form.
Dental
Use this form to file a claim for dental benefits under the SAIC Dental PPO Plan ONLY (administered by Aetna). DMO plans, including the Aetna DMO plan, do not use this claim form.
For contact or claims information, visit the Aetna web site http://www.aetna.com
Flexible Spending Accounts
Use the appropriate form for Health Care and Dependent Care Flexible Spending Account reimbursement claims.
Health Care Flexible Spending Account Claim Form
Dependent Care Flexible Spending Account Claim Form
Health Care Reimbursements: For all employees enrolled in a Health Care Spending Account.
Dependent Care Reimbursements: For all employees enrolled in a dependent care spending account.
For contact or claims information, visit the WageWorks, Inc. web site.
Life Event/Qualified Status Change Events
Gaining or losing a spouse or dependent due to any of these events:
- Marriage
- Divorce, separation or annulment
- Birth, adoption, or legal guardianship of a dependent
- Death of a dependent or spouse
- A child losing eligibility for coverage (attaining age 26).
If your spouse, your dependent(s) or you:
- Change employment status (termination, commencement),
- Change work schedule (reduction in hours of employment),
- Change residence or work site that affects an HMO service area,
- Have to pay an increased amount for benefits mid-year as a result of a health care plan or HMO increase,
- Become eligible for COBRA or
- Become entitled to Medicare or Medicaid (MediCal in California).
- Receive an issuance of a family relations judgment (QMCSO - a court order that may require you to provide your children with medical benefits, even if they are not in your custody).