Plan Documents
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Summary Annual Report
- Plan Year 2019-2020
- Plan Year 2018-2019
- Plan Year 2017-2018
- Plan Year 2016-2017
- Plan Year 2015-2016
- Plan Year 2014-2015
Summary Plan Description
Summary of Material Modifications
- 02/2021 Summary of Material Modification – COVID-19 Vaccines – Retiree 1,2,3,4 Basic
- 02/2021 Summary of Material Modification – Vision - Basic Plan
- 02/2021 Summary of Material Modification – Bariatric & Vision – Retiree Plans 1, 2 & 4
- 02/2021 Summary of Material Modification – Bariatric – Retiree Plan 3
- 02/2021 Summary of Material Modification – MAP – Retiree Plans 1, 2, 3 & 4
- 04/2020 Summary of Material Modification - COVID-19
- 04/2017 Summary of Material Modification - Smoking Cessation Benefits
- 01/2017 Summary of Material Modification - Retiree Plan 1 RX Change
- 01/2017 Summary of Material Modification - Retiree Plan 2-4 RX Change
- 05/2015 Summary of Material Modification - Same Sex Marriage
- 06/2014 Summary of Material Modification - Retiree Plans
- 04/2013 Summary of Material Modification - Retiree Plans 1-4
- 12/2012 Summary of Material Modification - Retiree Plans 1-4
- 11/2011 Summary of Material Modification - VSP Retiree Plans
- 06/2011 Summary of Material Modification - Retiree Basic Plan
- 06/2011 Summary of Material Modification - Retiree Plan 1
- 06/2011 Summary of Material Modification - Retiree Plan 2 and 4
- 06/2011 Summary of Material Modification - Retiree Plan 3
- 03/2011 Summary of Material Modification - ERRP Cover Letter
General Notices
- 12/2020 Womens Health Act
- 12/2019 Womens Health Act
- 12/2018 Privacy Notice
- 11/2018 Self-Pay Rates for Spouses
- 03/2017 Diabetic Medical Supplies Letter
- 03/2017 Medicare Crossover Announcement
- 12/2016 Notice of Privacy Practices/Women’s Health & Cancer Rights/Nondiscrimination Notice – All Plans
- 12/2015 Womens Health Act
- 2015 COBRA and Self-Pay Rates
- 12/2012 Waiver Notice - Basic Retiree Plan
- 12/2012 Notice of Privacy Practices/Women's Health & Cancer Rights Act - All Plans
- Affordable Care Act Marketplace Notice
- Nondiscrimination Notice Under Section 1557 of the Affordable Care Act