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City of Lake Elmo <br />September 26, 2025 <br />Page 3 <br /> <br />Employees and dependents who wish to change health plans or networks must complete an Enrollment <br />Form (or online enrollment) for the change. A primary care clinic number for each member is <br />required. Participants staying with the same carrier who wish to change their primary care clinic <br />must contact the carrier directly. <br /> <br />Primary care clinics can be changed at any time by calling the customer service number on the member’s <br />ID card. The PEIP 2026 clinic directory will be available on the PEIP website at innovomn.com by <br />October 13, 2025. IMPORTANT: Please be sure members review their clinics for any cost level <br />changes. <br /> <br />All completed enrollment forms and any changes to your group's eligibility requirements must be <br />submitted to Innovo Benefits Administration, PEIP's administrator, by November 16th. Please plan your <br />open enrollment to meet this deadline. No form is required for those employees maintaining current <br />coverage. <br /> <br />As the sponsor of the group insurance, you may change or add additional PEIP product options (e.g. life <br />and dental coverages) and change your eligibility requirements at this time. Eligibility criteria includes the <br />number of hours worked per week to be eligible, new employee waiting periods before coverage becomes <br />effective, etc. Any changes made to your current eligibility policy must be made in writing and sent to <br />Innovo. <br /> <br />Please submit all forms via fax, email , Innovo Portal or mail to: <br /> <br />Innovo Benefits Administration <br />Attn: PEIP <br />7805 Telegraph Road, Suite 110 <br />Bloomington, MN 55438 <br />Secure Fax: 952-746-3108 Email: service@innovomn.com <br /> <br />Please forward the renewal rate information to your COBRA, Minnesota continuation, disabled, and early <br />retiree participants (if any). If PEIP manages your COBRA, Innovo will send out the information to these <br />participants. <br /> <br />If you have any questions, please call 952-746-3101 or 1-800-829-5601 or email shawn@innovomn.com. <br />We look forward to another year of serving you. <br /> <br />Sincerely, <br /> Shawn Byrne <br />Manager <br /> <br />CC: Agent (if applicable)