Thursday, January 16, 2025

Health Care Documents

Health Care Forms
Health Care Forms
Dollar Bank Claim Form
Health Care Amendments and Modifications
Health Care Amendments and Modifications
Plan Restatement (2016)
Summary of Material Modifications (SMM) re:  Subrogation and Reimbursement provision
SMM re: Anti-Assignment Provision
SMM – Special Enrollment Provisions
SMM – Gene Therapy Exclusion
SMM – DOL Disability Regulations
SMM – Paladina Health
SMM 2020 – CARES Act
SMM 2023 – COVID PHE Ends
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Dollar Bank Filing Procedures
2020 SBC
Summary Plan Description
Sav-Rx Prescription Info
Health Reimbursement Plan (Dollar Bank)
Member’s Benefit Guide
Medical Mutual Benefit Booklet