If you are unable to print any of the forms below, contact Employee - Benefits 734-247-3236 firstname.lastname@example.org and a form will be mailed to the address on file. Submit all completed forms to:
Employee - Benefits
Wayne County Airport Authority
LC Smith Building Mezzanine
Detroit, MI 48242
Change of Address Notification (click here)
To change your address, contact Employee benefits at email@example.com or call 734-247-3236 (don’t forget to also notify Wayne County Retirement www.wcers.org 313-224-5890 of your address change). If a legal name change applies, provide a copy of the social security card issued with your new name, along with your change of address form.
Optical Reimbursement (click here)
WCAA provides its retirees and covered beneficiaries with vision benefits through an Optical Reimbursement Program. This program reimburses expenses incurred for prescription eyeglasses or contact lenses, prescription frames, and vision examinations rendered by a licensed optometrist, optician, or ophthalmologist within each benefit period. The current Benefit Period is 12/1/2015 – 11/30/2017. Details to follow.
The maximum reimbursement amount per eligible family member is specified in the current collective bargaining agreement (CBA). To receive reimbursement, submit this form along with an original, paid receipt specifically detailing the person receiving services, services rendered (or qualified items bought), and expenses incurred for each service/item. Without this information, reimbursements cannot be processed. A check will be mailed after the 1st pay period of the month to the address on file.
Health Care Insurance OPT OUT Election Form (click here)
If you have Health Insurance from a spouse you can Opt-Out of WCAA’s plan. You will need to submit a document of proof of outside medical coverage, the opt-out form, and complete the Enrollment Change of Status Form to indicate your choice of Opt-Out. Applicable Opt-Out amounts are paid out sometime early January.
Enrollment/Change Form (click here)
For a qualifying family status change (marriage, adoption of a child, divorce, death, childbirth), after the enrollment period, you have 30 days to make a change to your coverage. Please provide supporting documentation for the change. If the 30 day window is missed, the next opportunity will be during the following open enrollment. IMPORTANT: If a dependent is no longer eligible (i.e. ex‐spouse), you are responsible for paying 100% of the claims or premiums for any ineligible dependent remaining on the plan 30 days after the life event. In addition, dependents will lose their rights for continued coverage under COBRA.