Friday, May 16, 2025

Health Care Documents

Health Care Amendments and Changes
Health Care Amendments and Changes
Amendment No.1 VSP Benefit Changes
Amendment No. 2 Retiree Vision Care Benefit
Amendment No. 3 Purchase of Eligibility Hours
Amendment No. 4 to SPD
L1 HC -- Amendment No. 6 to SPD
L1 HC -- Amendment No. 5 to SPD
L1 HC -- Amendment No. 7 to SPD
Amendment No. 8 - Buy Up Change
Amendment No. 9 - Dental Annual Maximum
HW Amendment No. 10- Vision Care Changes
HC Amendment No.11 to SPD
HC Amendment No.12 to SPD
HC Amendment No.13 to SPD
HC Amendment No.14 to SPD
HC Amendment No.15 to SPD
Health Care Forms
Health Care Forms
UnitedHealthcare (formerly PacifiCare) Enrollment Form
Vital Enrollment Form
Address Verification Change Form
Kaiser Enrollment Form
Sav-Rx Summary of Benefits
VSP Summary of Benefits
2017 Ameritas Summary of Benefits
UHC 2020 Summary of Benefits and Coverage
Kaiser Summary of Benefits 2025
UHC Benefit Basics HMO Flier Spanish
UHC Benefit Basics HMO Flier
UHC Virtual Primary Care HMO CA Flier
Health Care Recent Mailings
Health Care Recent Mailings
Notice to Employees Regarding Health Care Marketplace Notice
Annual Gramm-Leach-Bliley(GLB) Privacy Notice
Summary of Material Modifications Regarding Plan Changes/Loss of Grandfathered Status
L1 HC Summary of Material Modification Regarding Changes to VSP Plan
Summary of Material Modification Regarding Amendment No2
Summary of Material Modification Regarding Amendment No. 3 to the SPD
SMM Regarding Amendment No.4 to SPD
Notice Regarding COVID-19 Memo
General Notice Regarding Extended Deadlines
Summary of Material Modification Regarding Dental Crowns
L1 HC Summary of Material Modification Regarding Prescription Out of Pocket Max
HW Notice to Participants Regarding Free COVID-19 Tests
L1 HW SMM Ameritas Dental Maximum Notification
L1 HC-- Summary Annual Report PYE 12-31-2023
L1 HW SMM Regarding Monthly Eligibility
Annual Creditable Coverage Notice October 2024
Annual Womens Cancer Rights & Newborns & Mothers Protection Act Notice 2024
SMM Regarding Vacation Fund
HW Summary of Material Modification Regarding Increase in Hour Bank Max
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Summary Plan Description effective 1-1-18
Information on COVID-19
Information on COVID-19
Flyer from Kaiser Regarding COVID-19 English
Flyer from Kaiser Regarding COVID-19 Spanish
Kaiser's Updated Telehealth Flyer (English & Spanish)
Kaiser Flyer How to Wear Mask
HW Notice to Participants Regarding Free COVID-19 Tests