2022 Summary Plan Descriptions

Medical

• Kaiser Permanente HMO (PDF)
• Kaiser Permanente HMO - Medicare (PDF)
• Cigna Healthcare HMO (PDF)
• Cigna Healthcare HMO - Medicare (PDF)
• Cigna Healthcare PPO (PDF)
• Cigna Healthcare PPO - Medicare (PDF)

Dental 

• Aetna Dental DMO (PDF)
• Aetna Dental PPO (PDF)

Prescription 

• Express Scripts (PDF)

Vision

• Vision Service Plan Base and Buy-Up Plan (PDF)

Flexible Spending Account 

• Benefit Strategies (PDF)

Voluntary Benefits

• Unum Accident Insurance (PDF)
• Unum Enhanced Critical Illness (PDF)
• Unum Whole Life Insurance (PDF)
• Unum Short-Term Disability (PDF)
• Aflac Supplemental Dental Insurance (PDF)
• Legal Resources (PDF)
• Legal Shield (PDF)

Your Rights and Responsibilities

• Benefit Notices 

Frequently Used Forms 

• Enrollment Change Form for Active Employees (PDF)
• Dependent Verification Cover Letter (PDF)
• ESS Guide to Update Beneficiary (PDF)
• Dental DMO Form (PDF)
• Medical Opt-Out Form (PDF)
• 30 Day Rule Reminder for Qualifying Life Events (PDF)
• Quick Reference Guide to Enroll in Benefits (PDF)