Sunday, January 25, 2026

Health Care Documents

Health Care Forms
Health Care Forms
Authorization for Release of Protected Health Information
Change of Address Form
Domestic Partnership Form
Enrollment Form
Life Insurance Beneficiary Form
Health Care Mailings
Health Care Mailings
FWIC Temporary Eligibility Freeze Notice - English
FWIC Temporary Eligibility Freeze Notice - Spanish
COVID-19 Notice
COBRA Rate Increase Notice January 2019
COBRA Rates January 2017 (Decrease)
May 2016 - SMM - Elimination of United HealthCare
SMM Break In Eligibility October 2016
EBSA Disaster Relief Notice 2021
FWIC 2022 Creditable Coverage Notice
FWIC COBRA Rate Increase Notice 01-2023
FWIC SMM Extended Eligibility
2023 Women's Health Notice
FWIC 2023 Creditable Coverage Notice
FWIC COBRA Rate Increase Notice 01-2024
FWIC 2024 Creditable Coverage Notice
FWIC COBRA Rate Increase Notice 01-2025
2025 Women's Health Notice
FWIC 2025 Creditable Coverage Notice
FWIC COBRA Rate Increase Notice 01-2026
FWIC - SBC 2026
Health Care Summary Plan Description
Health Care Summary Plan Description
Summary Plan Description January 2017
Health Care Information
Health Care Information
COBRA FAQ's
Delta Dental Benefits Summary
Delta Dental Evidence of Coverage 08-2021
How To Find a Delta Dental Dentist
MetLife Dental Benefits Summary
How To Use the Delta Dental Website
Summary of Plan Benefits
Kaiser Benefits Summary
VSP Member Benefits Eff. 11-1-2021
Kaiser Continuation of Coverage
Coronavirus 2019 (COVID-19) communications
Novel Coronavirus Memo
Kaiser January Monthly Health Topic - Fitness
Kaiser Tema de salud mensual de Enero - Acondicionamiento Fisico
Kaiser February Monthly Health Topic - Heart Health
Kaiser Tema de Salud Mensual de Febrero - Salud cardíaca
Kaiser March Monthly Health Topic - Nutrition
Kaiser Tema de Salud Mensual de Marzo - Nutrición
Kaiser SBC - 2021
Kaiser April Monthly Health Topic - Stress management
Tema de Salud Mensual de Abril - Manejo del Estres
Kaiser May Monthly Health Topic - Mental Health
Kaiser Tema de Salud Mensual de Mayo - Salud Mental
Kaiser June Monthly Health Topic - Men's Health
Kaiser Tema de Salud Mensual de Junio - Salud de los Hombres
Kaiser Tema de Salud Mensual de Julio - Proteccion Solar
Kaiser July Monthly Health Topic - Sun Safety
Kaiser August Monthly Health Topic - Weight Management
Kaiser Tema de Salud Mensual de Agosto - Control de Peso
Kaiser September Monthly Health Topic - Flu Prevention
Kaiser Tema de Salud Mensual de Septiembre - Prevencion de la Gripe
Kaiser October Monthly Health Topic - Women's Health
Kaiser Tema de Salud Mensual de Octubre - Salud de la Mujer
Kaiser November Monthly Health Topic - Diabetes Prevention
Kaiser Tema de Salud Mensual de Noviembre - Prevencion de la Diabetes
Kaiser December Monthly Health Topic - Mind-Body Wellness
Kaiser Tema de Salud Mensual de Diciembre -  Bienestar de la Mente y el Cuerpo
Important Information: COVID 19 Vaccine - Know the Facts
Important Information: COVID 19 Vaccine - What to Expect
Informacion Importante: COVID 19 Vacuna - Conozca los Datos
Informacion Importante: COVID 19 Vacuna - Que Sucedera
Kaiser Permanente - Navigating the Next Normal no-cost webinars Aug-Oct 2021
No Surprises Act Notice
Kaiser SBC - 2023
Health Care Summary Annual Reports
Health Care Summary Annual Reports
Summary Annual Report 2025
Summary Annual Report 2024
Summary Annual Report 2023
Summary Annual Report 2022
Summary Annual Report 2021
Summary Annual Report 2020
Summary Annual Report 2019
Summary Annual Report 2018
Summary Annual Report 2017
Summary Annual Report 2014
Summary Annual Report 2013
Summary Annual Report 2012
Summary Annual Report 2011
Health Care Creditable Coverage Notices
Health Care Creditable Coverage Notices
Creditable Coverage Notice 2010
Creditable Coverage Notice 2011
Creditable Coverage Notice 2012
Creditable Coverage Notice 2013
Creditable Coverage Notice 2014
Creditable Coverage Notice 2015
Creditable Coverage Notice 2016
Creditable Coverage Notice 2017
Creditable Coverage Notice 2018
Creditable Coverage Notice 2019
Creditable Coverage Notice 2020
Creditable Coverage Notice 2021
Creditable Coverage Notice 2022
Creditable Coverage Notice 2023
Creditable Coverage Notice 2024