Documents and Resources

General Plan Documents

Insurance Provider Documents


2026 PLAN YEAR:


Premier PPO Summary of Benefits and Coverage
Premier PPO Benefit Summary
Classic Plus PPO Summary of Benefits and Coverage
Classic Plus PPO Benefit Summary
Platinum HMO Summary of Benefits and Coverage
Platinum HMO Benefit Summary
High Deductible Health Plan w/ Health Savings Account (HSA Plan) Summary of Benefits and Coverage
High Deductible Health Plan w/ Health Savings Account (HSA Plan) Benefit Summary
Silver Select HMO Summary of Benefits and Coverage
Silver Select HMO Benefit Summary
Vision Benefit Summary
Dental Summary of Benefits and Coverage
Dental Benefit Summary
Dental Certificate of Coverage
Short Term Disability Benefit Summary - California Residents
Short Term Disability Benefit Summary - Non-California Residents
Long Term Disability Benefit Summary - California Residents
Long Term Disability Benefit Summary - Non-California Residents
Basic Life and Accidental Death and Dismemberment Benefit Summary - Freelance
Basic Life and Accidental Death and Dismemberment Benefit Summary - Staff - $25,000 Benefit Level
Basic Life and Accidental Death and Dismemberment Benefit Summary - Staff - $50,000 Benefit Level
Supplemental Life Benefit Summary - Freelance
Supplemental Life Benefit Summary - Staff
Voluntary Accident Benefit Summary
Voluntary Critical Illness Benefit Summary
Voluntary Hospital Indemnity Benefit Summary


HSA 2026 FAQs
HSA Spendiing Account Web Portal Guide

HSA Deposit Instructions
HSA Account Holder Contribution Form (not for employers)
HSA Contribution Correction Form
HSA Investments Quick Reference Guide
HSA Investments Comprehensive Reference Guide
HSA Guide to Disenrollment - What Happens to your HSA if your PHBP Coverage Terminates
Voluntary Benefit Claim Forms - Accident, Critical Illness, Hospital Indemnity
Voluntary Benefit Portability - Extension of Coverage if your PHBP Coverage Terminates
Supplemental Life Insurance Portability and Conversion Details
Supplemental Life Insurance Portability Application
Supplemental Life Insurance Conversion Application
Employee Assistance Program


CERTIFICATES / EVIDENCE OF COVERAGE

Premier PPO
Classic Plus PPO
California Classic Platinum HMO
High Deductible Health Plan w/ Health Savings Account (the “HSA Plan”)
Vision
Dental
Basic and Voluntary Life - Freelance - CA
Basic and Voluntary Life - Freelance - Non-CA
Basic and Voluntary Life - Staff - $25k Benefit Level - CA
Basic and Voluntary Life - Staff - $50k Benefit Level - CA
Basic Life - Staff - $25k Benefit Level - Non-CA
Basic Life - Staff - $50k Benefit Level - Non-CA
Short Term Disability - Freelance - CA
Short Term Disability - Freelance - Non-CA
Short Term Disability - Staff w/ $25k Basic Life - CA
Short Term Disability - Staff w/ $50k Basic Life - CA
Short Term Disability - Staff w/ $25k Basic Life - Non-CA
Short Term Disability - Staff w/ $50k Basic Life - Non-CA
Long Term Disability - Freelance - CA
Long Term Disability - Freelance - Non-CA
Long Term Disability - Staff w/ $25k Basic Life - CA
Long Term Disability - Staff w/ $50k Basic Life - CA
Long Term Disability - Staff w/ $25k Basic Life - Non-CA
Long Term Disability - Staff w/ $50k Basic Life - Non-CA
Accident Insurance - Freelance
Accident Insurance - Staff
Critical Illness Insurance - Freelance
Critical Illness Insurance - Staff
Hospital Indemnity Insurance - Freelance
Hospital Indemnity Insurance - Staff

Participating Employer Documents

Participating Freelancer Documents

PARTICIPATING STAFF EMPLOYEE DOCUMENTS