Benefit Plan Contact Information

Administrative Information

Important administrative information for each Leidos benefit plan is described in this section. For a comprehensive contact list, go to Contact Information.

Leidos Benefit Plan	Healthy Focus Plans
Type of Plan	Group health plans
Plan Sponsor & Administrator	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Group Number	Aetna – 698685
Plan Number	501
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	The plans are self-funded and self-administered by Leidos. Leidos and participants share the cost of coverage.
Claims Administrators:	Aetna P.O. Box 14089 Lexington, KY 40512-4089 800-843-9126 Express Scripts P.O. Box 14711 Lexington, KY 40512 877-223-4721

Leidos Benefit Plan	Leidos Dental PPO Plans
Type of Plan	Group dental plans
Plan Sponsor & Administrator	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Group Number	700273
Plan Number	501
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	The plans are self-funded and self-administered by Leidos and participants share the cost of coverage.
Claims Administrator	Delta Dental 4818 Starkey Road Roanoke, VA 24018 800-237-6060

Leidos Benefit Plan	Vision Plans
Type of Plan	Group vision plans
Plan Sponsor & Administrator	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Group Number	12180678
Plan Number	514
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Fully insured. Participants pay the full cost of coverage. To be covered by benefits, participants make pre-tax contributions.
Claims Administrators	Vision Service Plan 3333 Quality Drive Rancho Cordova, CA 95670 800-852-7600

Leidos Benefit Plan	Basic Term Life Insurance, Group Universal Life (GUL) Insurance, Basic AD&D Insurance, and Voluntary AD&D Insurance
Type of Plan	Life Insurance Accidental Death & Dismemberment
Plan Sponsor	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Plan & Claim Administrator	Life Insurance Prudential Insurance Company of America P.O. Box 8517 Philadelphia, PA 19176 AD&D Insurance New York Life Group Benefit Solutions P.O. Box 22328 Pittsburgh, PA 15222-0328
Policy Number	Prudential Life Insurance - Control 52844 New York Life Basic AD&D - COA 004005 New York Life Voluntary AD&D - OK 819515
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Fully insured. Leidos pays the full cost of Basic Term Life Insurance and Basic AD&D Insurance. Participants pay the full cost of coverage for Group Universal Life (GUL) Insurance and Voluntary AD&D Insurance.
Claim Forms	Claim forms are available through Employee Services. Completed claim forms, along with supporting documentation, should be submitted directly to Employee Services: P.O. Box 2502 Oak Ridge, TN 37831

Leidos Benefit Plan	Business Travel Accident Insurance
Type of Plan	Group business travel accident insurance plans
Plan Sponsor	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Plan & Claim Administrator	New York Life Group Benefit Solutions P.O. Box 22328 Pittsburgh, PA 15222-0328
Policy Number	ABL-65 86 41
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Fully insured. Leidos pays the full cost of Business Travel Accident Insurance.
Claim Forms	Claim forms are available through Employee Services. Completed claim forms, along with supporting documentation, should be submitted directly to Employee Services: P.O. Box 2502 Oak Ridge, TN 37831

Leidos Benefit Plan	Voluntary Short-Term Disability Insurance (VSDI)
Type of Plan	Disability plan
Plan Sponsor & Administrator	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Plan & Claim Manager	Sedgwick 3280 E. Foothill Blvd., Suite 250 Pasadena, CA 91107 877-399-6443
Plan Number	515
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Fully insured. Employees pay the full cost of Voluntary Short-Term Disability Insurance (VSDI).

Leidos Benefit Plan	Long-Term Disability Insurance
Type of Plan	Disability plan
Plan Sponsor	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Plan & Claim Administrator	Life Insurance Company of North America 1601 Chestnut Philadelphia, PA 19192-2235
Plan Number	LK-980003
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Fully insured. Employees pay the full cost of Voluntary Long-Term Disability Insurance on an after-tax basis.

Leidos Benefit Plan	Health Care FSA and Dependent (Day) Care FSA
Type of Plan	Group health and welfare plans
Plan Sponsor	Leidos Attn: Corporate Benefits 1750 Presidents Street Reston, VA 20190
Plan Sponsor Employer Identification Number	95-3630868
Plan & Claim Manager	HealthEquity 15 W. Scenic Pointe Drive Suite 100 Draper, UT 84020 Customer Service: 1-844-373-6981 HealthEquity
Agent for Service of Legal Process	Legal process may be served on the Plan Administrator at the address specified above.
Plan Year	January 1 – December 31
Funding	Self-funded. Benefits are funded with voluntary pre-tax contributions made by enrolled participants.

Plan Contact Information

Benefit	Contact & Group Number	Phone Number	Other Info
U.S. Employees (Except Leidos Biomedical Research, QTC, Gibbs & Cox, and Dynetics)	Employee Services	855-553-4367, option 3	[email protected]
International Subsidiaries	Contact your in-country HR Department
Leidos Self-Insured Medical Plans Administered by Aetna Healthy Focus Plans	Aetna Group #698685	800-843-9126	AETNA
Leidos Self-Insured Plans Prescription Benefits Healthy Focus Plans	Prescription benefits provided by Express Scripts Group #SAICRX1	877-223-4721	Express Scripts Submit retail Rx claims to: Express Scripts P.O. Box 14711 Lexington, KY 40512
All Fully-Insured Plan Inquiries (Kaiser Mid-Atlantic, Kaiser CA, Kaiser HI, HMSA HI, Cigna International, Tricare Supplement, Triple S - Puerto Rico)	Primary - Plan's Customer Service		HR Services
COBRA	Wageworks	877-722-2667	Wageworks P.O. Box 650407 Dallas, TX 75265-0407
DMO Dental Plan Provider	Aetna DMO Group #698685-51	800-843-9126	AETNA
PPO Dental Plan Provider	Leidos Dental PPO (administered by Delta Dental) Group #700273	800-237-6060	Delta Dental
Dependent Eligibility Verification (DEV)	Budco	866-488-2001 866-887-8073 (fax)	Budco Health Solutions P.O. Box 8072 Royal Oak, MI 48068
Vision Service Plan (VSP)	VSP Group #12180678	800-877-7195	VSP
Flexible Spending Accounts and Health Savings Account	HealthEquity	844-373-6981	HealthEquity
Backup and In-Home Child/Elder Care	Bright Horizons		Bright Horizons
Short Term Disability Claims (DSL, VSDI, CA State Disability)	Sedgwick	877-399-6443 (to file a claim) 877-393-0018 (fax)	Employees should contact Sedgwick no earlier than 30 days before anticipated disability
Long Term Disability Claims	Cigna	800-781-2006
Stock Information Including Equity Awards and ESPP	Computershare	855-894-5367	Computershare
Leidos Retirement	Vanguard	800-523-1188	Vanguard
Basic Life Insurance	Prudential	For general questions, contact Leidos Employee Services. For approval for additional life insurance, contact Prudential at 888-257-0412
Group Universal Life (GUL) & Cash Accumulation Fund (CAF)	Mercer	855-735-4873
Accidental Death & Dismemberment Insurance	New York Life	For general questions, contact Employee Services
Voluntary Benefits and Leidos Discount Program	Beneplace	800-683-2886	Beneplace
Telemedicine (Available to Healthy Focus Plan participants)	Teladoc	800-835-2362	Teladoc
Commuter Benefits	Wageworks	877-924-3967	Wageworks
Diabetes Management Program (Available to Healthy Focus Plan participants)	Livongo	800-945-4355	Livongo
Well-Being Program	Virgin Pulse	888-671-9395	Virgin Pulse