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  • PLAN DOCUMENTS & NOTICES

    Plan Documents:

    Summary Plan Description (“SPD”) + Summary of Material Modifications (“SMM”):

    The SPD summarizes the key provisions of the Plan and includes important information about your benefits from the Plan. The SPD is updated from time-to-time and therefore includes additional information and changes to the Plan in the form of a SMM.

    DOWNLOAD  SPD  
    DOWNLOAD  SMM  

    Summary of Benefits and Coverage (“SBC”):

    This document provides you with a quick reference to covered expenses, deductibles and out-of pocket costs. This is not a full explanation of the benefits covered by the Plan. For more information about the benefits covered by the Plan, see the enclosed Summary Plan Description and Benefit Alerts.

     
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    Important Notifications:

    Notice of Privacy Practices:

    This document provides you with a quick reference to covered expenses, deductibles and out-of pocket costs. This is not a full explanation of the benefits covered by the Plan. For more information about the benefits covered by the Plan, see the enclosed Summary Plan Description and Benefit Alerts.

     
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    Women’s Health and Cancer Rights Act Notice:

    This notice includes important information about protections for individuals who elect breast reconstruction in connection with a mastectomy. You will also receive this notice, annually, via US Mail.

     
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    Summary Annual Report:

    The Summary Annual Report provides insurance and basic financial information regarding the Plan and informs you of your rights to additional information.

     
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