2022 JL Marine Systems Benefits at a Glance

Required Annual Employee Disclosure Notices continued Required Annual Employee Disclosure Notices

GEORGIA-Medicaid Wpreebmsiiutem: h-pttapysm://emnte-pdricoagidra.gmeo-hrgipiap.gov/health-insurance- Phone: 678-564-1162 ext 2131 INDIANA-Medicaid HWeeabl st hi tye : Ihntdtpi a: /n/awPwl awn.i nf o.gro vl o/wf ss-ai n/ hc oi pm/ e a d u l t s 1 9 - 6 4 AP hl loonteh:e1r -M8 7e7d-i4c 3a i8d-4 4 7 9 WPheobnseite1:-h8t0tp0s-4:/5/7w-4w5w8.4in.gov/medicaid/ IOWA-Medicaid and CHIP (Hawki) Mhttepdsi:c/a/iddhsW.ioewbsai.tgeo:v/ime/members MHaewdikciaWidePbhsoitne:e: 1-800-338-8366 hHtat pw: /k/i dPhhso. i onwe :a1. g-o8v0/0H- 2a w5 7k-i8 5 6 3 HhtItpPsP://Wdhebs.sioitwe:a.gov/ime/members/medicaid-a-to-z/hipp HIPP Phone: 1-888-346-9562 KANSAS-Medicaid WP heobnseit:e1: -h8t0tp0s-:7/9/w2-w48w8.k4ancare.ks.gov/ P K r e o n g t r u a c m ky ( I K n I t - e H gr I a P t P ed ) H W e e a b l s th ite I : nsurance Premium Payment https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: KIHIPP.PROGRAM@ky.gov K C H I P Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov LOUISIANA-Medicaid WP heobnsei t:e 1: w- 8w8 8w- 3. m4 e2 d- 6i c2a0i 7d . (l aM. geodvi coari dw hwowt l .ilnd eh). l ao. rg o1v- /8 l5a5h-i 6p 1p 8 - 5488 (LaHIPP) MAINE-Medicaid Ehtntpros:l/lm/wewntwW.meabisniete.g:ov/dhhs/ofi/applications-forms TP hToYn:eM: 1a-i8n0e0r-e4l4a2y -761010 3 r g 7 n v 0 c/edhPhrse/mofiiu/mapWpliecbatpioanges-:forms a o 4 TTY: Maine relay 711 KENTUCKY-Medicaid h P P t r h t i p o v s n a : t / e e / : Hw 1- e w 8 a 0 w lt 0 . h m -9 I a 7 n in 7 su e -6 .

MASSACHUSETTS-Medicaid and CHIP pWreebmsiiutem: h-attspssis:/ta/nwcwe-wp.amass.gov/info-details/masshealth- Phone: 1-800-862-4840 MINNESOTA-Medicaid Whttepbss:i/t/em: n.gov/dhs/people-we-serve/children-and- fsaemrviilcieess//hoethaletrh--icnasruer/ahnecael.tjhsp-care-programs/programs-and- Phone: 1-800-657-3739 MISSOURI-Medicaid W ht e tp b : s / it / e w : ww.dss.mo.gov/mhd/participants/pages/hipp. htm Phone:573-751-2005 MONTANA-Medicaid Whttepb:s/i/tde:phhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 NEBRASKA-Medicaid WPheobnseit:e1: -h8t5tp5:-/6/3w2-w76w3.A3 CCESSNebraska.ne.gov L O i m nc a o h l a n : : 4 4 0 0 2 2 - - 5 4 9 7 5 3 - - 1 7 1 0 7 0 8 0

NEVADA-Medicaid

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NEW HAMPSHIRE-Medicaid WPheobnseit:e6: h0t3t-p2s7:/1/-5w2w1w8 .dhhs.nh.gov/oii/hipp.htm eTxotl5l 2fr1e8e number for the HIPP program: 1-800-852-3345,

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