Benefits

You can download the current Contract by clicking on the links below:

2022 Dental Plan DHMO ( 840.49 KB)

2022 Dental Plan PPO High ( 832.53 KB)

2022 Dental Plan PPO Low ( 833.30 KB)

2022 Group Accident and Hospital Indemnity Brochure ( 8681.54 KB)

2022 Group Accident Insurance Certificate ( 569.79 KB)

2022 Group Hosp Indemnity Certificate ( 625.72 KB)

2022 HIPAA OPT-OUT NOTICE ( 89.22 KB)

2022 Medical Plan ( 1799.25 KB)

2022 Summary Plan Description ( 331.06 KB)

EAP Provider List ( 690.57 KB)

Humana Vision Plan ( 2421.99 KB)

List of Lab Tests Performed in Wellness Center Laboratory ( 86.42 KB)

List of Medications from Wellness Center ( 164.44 KB)

New Health Insurance Marketplace Coverage Notice ( 269.70 KB)

Notice of Privacy Practices ( 47.75 KB)

Recommended Annual Health Guidelines ( 640.95 KB)

RSL Bereavement Support Services ( 334.07 KB)

RSL Group Life (Vol Term) ( 552.17 KB)

RSL Group Life Insurance (Employer Paid) ( 101.48 KB)

SavRx Mail Order Form ( 433.80 KB)

SavRx Medication Formulary List ( 278.92 KB)

Transparency in Coverage ( 344.27 KB)

Wellness Center Services ( 134.27 KB)

Last updated: Jan. 29, 2022

 

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