Documents and Resources
General Plan Documents
2019 Summary Plan Description (SPD)
2020 Summary of Material Modifications (SMM)
2020 - 2021 Summary of Material Modifications (SMM)
2021 Summary of Material Modifications (SMM)
2022 Summary of Material Modifications (SMM)
2023 Summary of Material Modifications (SMM)
2024 Participation Agreement
2022 Trust Agreement
Policy and Procedures for the Collection of Contributions
2023 Summary Annual Report
2022 Summary Annual Report
2021 Summary Annual Report
2020 Summary Annual Report
2019 Summary Annual Report
Insurance Provider Documents
2025 Anthem Premier PPO Summary of Benefits and Coverage
2025 Anthem Premier PPO Benefit Summary
2025 Anthem Plus PPO Summary of Benefits and Coverage
2025 Anthem Plus PPO Benefit Summary
2025 Anthem High Deductible Health Plan HSA Summary of Benefits and Coverage
2025 Anthem High Deductible Health Plan HSA Benefit Summary
2025 Anthem HSA Web Portal Guide
2025 Anthem Wealthcare Saver HSA Investment Guide
2025 Anthem Wealthcare Saver HSA Investments Quick Reference Guide
2025 HSA FAQs
2025 Anthem HMO Summary of Benefits and Coverage
2025 Anthem HMO Benefit Summary
2025 Anthem Vision Benefit Summary
2025 Anthem Dental Summary of Benefits and Coverage
2025 Anthem Dental Benefit Summary
2025 Anthem Basic Life Insurance Summary of Benefits - Freelancers
2025 Anthem Basic Life Insurance Summary of Benefits - Staff - $25,000 Benefit Level
2025 Anthem Basic Life Insurance Summary of Benefits - Staff - $50,000 Benefit Level
2025 Anthem Supplemental Life Insurance Benefit Summary - Freelancers
2025 Anthem Supplemental Life Insurance Benefit Summary - Staff
2025 Anthem Short Term Disability Benefit Summary - California
2025 Anthem Short Term Disability Benefit Summary - Non-California
2025 Anthem Long Term Disability Benefit Summary - California
2025 Anthem Long Term Disability Benefit Summary - Non-California
2025 Anthem Long Term Disability Claim Form
2025 Anthem Voluntary Benefits - Accident
2025 Anthem Voluntary Benefits - Critical Illness
2025 Anthem Voluntary Benefits - Hospital Indemnity
2025 Anthem Voluntary Benefits Claim Form
2025 Anthem Voluntary Benefits - Extended Continuation / Portability of Benefits
2025 Anthem Supplemental Life Insurance Portability and Conversion Details
2025 Anthem Supplemental Life Insurance Portability Application
2025 Anthem Supplemental Life Insurance Conversion Application
2024 Anthem Classic HMO Benefit Summary
2024 Anthem Classic HMO Summary of Benefits and Coverage
2024 Anthem Classic Plus Benefit Summary
2024 Anthem Classic Plus Summary of Benefits and Coverage
2024 Anthem Premier PPO (California) Summary of Benefits and Coverage
2024 Anthem Premier PPO (California) Benefit Summary
2024 Anthem HDHP with HSA Summary of Benefits and Coverage
2024 Anthem HDHP with HSA Benefits Summary
2024 Anthem Accident Benefit Summary
2024 Anthem Critical Illness Benefit Summary
2024 Anthem Hospital Indemnity Benefit Summary
2024 Anthem Dental Summary of Benefits
2024 Anthem Dental Benefit and Coverage Summary
2024 Anthem Vision Plan Summary of Benefits
2024 Anthem Life Insurance Benefit Summary Freelance
2024 Anthem Life Insurance 25K Summary Benefit Staff
2024 Anthem Life Insurance Benefit Summary Freelance - Supplemental
2024 Anthem Life Insurance 50K Summary Benefit Staff
2024 Anthem Life Insurance Benefit Summary Staff - Supplemental
2024 Anthem Long Term Disability Insurance Summary Benefits Non-California
2024 Anthem Long Term Disability Insurance Summary Benefits California
2024 Anthem Short Term Disability Insurance Summary Benefits California
2024 Anthem Short Term Disability Insurance Summary Benefits Non-California
Participating Employer Documents
Participating Freelancer Documents
COBRA Qualifying Event Form
Consent to receive Plan Documents electronically
Monthly Auto Payment / ACH Form
Work History Correction Form
Global Core Travel Benefits
Traveling Out of Town or Abroad
How to Find a Doctor Instructions
How to file a short-term disability claim
Anthem Disability due to pregnancy
Coronavirus (COVID 19) Updates
COVID-19 Emergency Health Measures Extended until November 11, 2023
Coronavirus Relief Announcement - August Update
Coronavirus Relief Announcement - July Update
Coronavirus Relief Announcement - June Update
Coronavirus Relief Announcement - May Update
Coronavirus Relief Announcement - March
Small Business Owner's Guide to the CARES Act
PHBP Announcement March 13, 2020
Anthem Important facts about coronavirus
Anthem Coronavirus FAQ Sheet
Anthem COVID-19 Employee Assistance Program (EAP) Resource Flyer- English
Anthem COVID-19 Employee Assistance Program (EAP) Resource Flyer- English
Department of Managed Health Care Coverage Options