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Archive

1095 Code Definitions
122022 Adoption and Surrogacy Reimbursement Program
1f50d92c-4b94-4aa5-a8c4-545d8fe4eecc
2021 COBRA Rates
2021_RRSP_Tax_receipts_and_slips
2022 California Voluntary Disability Plan Benefit Rate and Limit Changes
2022 Imputed Income Chart
2022 Insurance Introduction (PRC)
2022 Medical Comparison Chart
2022 Open Enrollment FAQs
2022 Spotlight Schedule_Aug_December (2)
2022年度保险说明(中国籍)
401(k) Summary Annual Report 2019
401(k) Summary Annual Report 2020
401(k) Summary Annual Report 2021
5dba084a-1764-410c-9226-24a4b59bd55f
保险手册(中国籍)
保险手册(外籍)
Adoption Surrogacy Reimbursement form 2022
Affordable Care Act (ACA) Preventive Services List October 1 2022_204G_106 (2)
Annual Compliance Notice 2021
Annual Compliance Notice 2022
ARAG Group Legal Summary
ARAG Mobile App Flyer
Arbitration Fact Sheet – California
Arbitration Fact Sheet – Hawaii
Beneficiary Designation and Changes
Beneficiary Designation and Changes
理赔申请表
理赔申请表(英文)
California VMW Voluntary Disability Plan Benefit Rate & Limit Changes 2021
cb028921-815e-4fcc-860b-298f0114b43e
Childcare: Emerging Solutions
Claim Form
Claims and Preauthorization guidelines
College Coach Event Fact Sheet_VMware, Inc.
CollegeAdmissionsTimeline
CollegeAdmissionsTimeline
CollegeCoachFAQ
Commuter Parking FAQ Flyer – 2023 Plan Year
COVID-19 OTC Test
CVS Caremark Formulary Drug Removal
Delta Dental – BrushSmart
Delta Dental – Toothpic
Delta Dental – Virtual Consult
Delta Dental Benefit Highlights 2020
Delta Dental Evidence of Coverage (EOC)
Direct Member Reimbursement Flyer
Domestic_Partner_Imputed_Income_Rate_Table
Employee Contributions 2021
Employee_Contributions
Employee_Contributions-2021
Exclusive-Member-Extras-VSP
Fidelity 401k Plan Highlights FAQ
Flexible Spending Account Summary Annual Report 2020
Form 1095 Frequently Asked Questions 2021
Fubon Insurance Program Handbook
GeoBlue Business Traveler Member Guide
Grand Rounds Photo
Grand Rounds Photo
HDHP-HSA Preventive Drug List
Health and Welfare Summary Annual Report 2020
Health Care Reform Exchange Notice 2020
HIPAA Privacy Notice
ICAS-Brochure-English-Malaysia
Insurance Handbook (Non PRC)
Insurance Handbook (PRC)
Insurance Program Scheme
Kaiser Foundation Health Plan California Arbitration Agreement
Kaiser HMO CA Evidence Of Coverage (EOC) 2022
Kaiser HMO Chiropractic and Acupuncture Evidence of Coverage (EOC) 2022
Kaiser HMO HI Evidence of Coverage (EOC) 2020
Kaiser HMO HI Evidence of Coverage (EOC) 2021
Kaiser HMO HI Evidence Of Coverage (EOC) 2022
Kaiser HMO HI Summary of Benefits and Coverage (SBC) 2020
Kaiser HMO N CA Chiropractic & Acupuncture Evidence of Coverage (EOC) 2020
Kaiser HMO N CA Evidence of Coverage (EOC) 2020
Kaiser HMO N.CA 2020 Benefit Plan Summary
Kaiser N CA Summary of Benefits Coverage (SBC) 2021
Kaiser Permanente Hawaii Arbitration Agreement
KPCA_2023_VMware_SBC_HMO
KPHI_2023_VMware_SBC_HMO
Manager Tool Kit Leave of Absence Process
Massage Therapy Claim Instructions
MavenMilkOverview
Medical Plan Comparison Chart 2020
Medical_Plan_Comparisons
Medical-Plan-Benefits-Guide
Medicare Part D Creditable Coverage Notice 2021
Meet Wellthy
Non-Qualified Deferred Compensation Guide 2022
NYL ADD Conversion Form
NYL Life Portability Basic EE and Vol EE.SP.CH
NYL LINA Life Conversion
NYL Portability vs Conversion Chart
OE Webinars
OE_Landing_Page_Final
Online Benefits Fair Webinars
Online Benefits Fair Webinars
Open Enrollment Important Updates 2022
Opt-In to Receive Form 1095-C Electronically
PayingforCollegeTimeline
PayingforCollegeTimeline
Pre-authorization-form
pre-FAQ-2022-Open-Enrollment-(final)
Preventive drug list – November 2022
Standard Performace Control Formulary
The Complete HSA Guidebook 13th Edition
TRI-AD Dependent Care FSA Provider Certification Form
UHC Harvard Pilgrim- Traditional Choice Plus SBC (2023)
UHC HSA Choice Plus SBC ( 2023)
UHC HSA Choice Plus- Harvard Pilgrim SBC(2023)
UHC HSA PPO Harvard Pilgrim Summary of Benefits and Coverage (SBC) 2020
UHC HSA PPO Summary of Benefits and Coverage (SBC) 2020
UHC HSA PPO Summary of Benefits Coverage (SBC) 2021
UHC HSA PPO Summary Plan Description (SPD) 2020
UHC Traditional Choice Plus SBC ( 2023)
UHC Traditional PPO Harvard Pilgrim Summary of Benefits and Coverage (SBC) 2020
UHC Traditional PPO Harvard Pilgrim Summary of Benefits and Coverage (SBC) 2021
UHC Traditional PPO Summary of Benefits and Coverage (SBC) 2020
UHC Traditional PPO Summary of Benefits Coverage (SBC) 2021
UHC Traditional PPO Summary Plan Description (SPD) 2020
UHC-Preventive-Care-Services-1-1-2020
UK-Cycle-to-Work-FAQ-Updated December 2022
US Benefits Summary 2020
US New Hire Benefits Checklist
US-Benefits-Summary-2020-revised-7.2.20
US-CVS-ACA-Preventive-Drug-List
US-Intern-Benefits-FAQ
US-New-Hire-Benefits-FAQ
VMW 2022-10-06 2023 Delta Dental Benefit Summary
VMW 2023 COBRA Rates
VMW 2023 COBRA Rates (2)
VMW 2023 Domestic Partner Imputed Income Chart
VMW 2023 Employee Contributions
VMW 2023 Enrollment Guide L2c 101322 (FINAL)
VMW 2023 Medical Plan Comparison
VMW Open Enrollment FAQ 101322 (FINAL)
VMware & Included Health How to Guide
VMware 2021-10-08 VSP 12122074-Dual MBS 2022
VMware 2021-10-18 2022 UHC HSA Choice Plus HP SBC
VMware 2021-10-18 2022 UHC HSA Choice Plus Trad SBC
VMware College Coach 2023
VMware Inc College Coach Event Fact Sheet_FINAL
VMware-CVS-Caremark-Rx-Summary-Plan-Attachment
Voya Wellness Benefit Summary
VSP Benefit Summary 2020
VSP Evidence of Coverage
VWM OE Email -Web TV Annoucement-Updated
Workday Quick Reference Guide_Review-401k-Contributions
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Benefit Descriptions

ARAG Group Legal Summary
CVS Caremark RX Benefits at a Glance Traditional PPO
Delta Dental Summary of Benefits & Coverage
Kaiser HMO HI Benefit Summary 2020
Kaiser HMO N CA Benefit Summary 2020
New York Life: AD&D Insurance Overview
New York Life: Basic Life Insurance Overview
New York Life: Long Term Disability Overview
New York Life: Supplemental Life Insurance Overview
Summary Plan Description D5831 Voya Accident
Summary Plan Description D5837 Voya Critical Illness
Summary Plan Description D5838 Voya Hospitalization Indemnity
UHC HSA PPO Benefit Summary 2020
UHC Traditional PPO Benefit Summary 2020
US-07-2020-PDL-Standard-Control-Advanced-Control-Specialty
US-Eyeconic-Overview
VSP Vision Benefit Summary
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Compliance Notices

401(k) Summary Annual Report 2021
Annual Compliance Notice 2023
COVID 19 Notice of Temporary Summary of Benefit Changes UHC Medical Plans
Drug Free Workplace Policy February 2020
Flexible Spending Account Summary Annual Report 2021
Health and Welfare Summary Annual Report 2021
Health Care Reform_Exchange_Notice_2022
HIPAA Notice of Privacy Practices
Medicare Part D Creditable Coverage Notice 2022
Voya Certificate of Coverage D5831 Accident Insurance
Voya Certificate of Coverage D5837 Critical Illness
Voya Certificate of Coverage D5838 Hospitalization
Expand all

Forms

Delta Dental Claim Form
HealthEquity Transfer Request Form
HIPAA Disclosure Authorization
HIPAA Release of Information-Form Optum Behavioral Health
HSA Proof of Other Medical Coverage Form
Kaiser HMO HI Claim Form
Kaiser HMO N CA Claim Form
Kaiser HMO N. CA Emergency Claim Form
Kaiser HMO N. CA Pharmacy Refill Form
Mandatory State Forms Voya Accident
Mandatory State Forms Voya Critical Illness
Mandatory State Forms Voya Hosptialization Indemnity
Massage Therapy Claim Filing Instructions
New York Life: Evidence of Insurability Form
New York Life: Supplemental Life Affidavit of Disabled Dependent Child Form
New York Life: Supplemental Life Evidence of Insurability (EOI) Form
Norway-Member-Certificate
TRI-AD FSA Claim Form
UHC Gender Dysphoria Hair Removal and Voice Therapy Claim Form
UHC Health Insurance Claim Form
UHC HIPAA Disclosure Authorization Form Medical
Voya Coverage Rates – Employee
Voya Coverage Rates – Spouse/Child
Voya Portability Coverage Form – Employee
Voya Portability Coverage Form – Spouse/Child
VSP Out-of-Network Reimbursement Form
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New Hire Notices

401(k) Savings Plan Summary Plan Description (SPD) 2022
Health Care Reform_Exchange_Notice_2022
HIPAA Notice of Privacy Practices
Medicare Part D Creditable Coverage Notice 2022

Quick Links

UK AXA – Travel Insurance Handbook

State Specific Notices

2023 California Voluntary Disability Plan Benefits Rate and Limit Changes
2023 Colorado Paid Family Leave Medical Notice Poster
2023 Oregon Paid Leave Notice Poster
California Disabillity Leave EDD de2515
California Paid Family Leave EDD de2511
California Programs for Unemployed EDD de2320
California Rights of Victims of Domestic Violence, Sexual Assault and Stalking Notice
California San Francisco Fair Chance Ordinance 2022
California San Francisco Health Care Security Ordinance 2023
California VMW Voluntary Disability Plan Summary Plan Document (SPD) 2020
California Workers Compensation Notice
Connecticut Paid Leave – Notice of Employee Rights
District of Columbia Paid Family Leave Notice
Georgia Workers Compensation Bill of Rights
Georgia Workers Compensation Notice
Massachusetts Paid Family Leave Notice
New York Paid Family Leave Notice
San-Francisco-Fair-Chance-Ordinance
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Summary of Benefits Coverage

Form 1095C FAQs
Health & Welfare and Cafeteria Plan Summary Plan Description 2022
Kaiser HMO California Summary of Benefits & Coverage (SBC) 2022
Kaiser HMO Hawaii Summary of Benefits & Coverage (SBC) 2022
UHC HSA PPO Summary of Benefits & Coverage (SBC) 2022
UHC HSA PPO-Harvard Pilgrim Summary of Benefits & Coverage (SBC) 2022
UHC Traditional PPO Summary of Benefits & Coverage (SBC) 2022
UHC Traditional PPO-Harvard Pilgrim Summary of Benefits & Coverage (SBC) 2022
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Summary Plan Descriptions

401(k) Savings Plan Summary Plan Description (SPD) 2022
California VMW Voluntary Disability Plan Summary Plan Document (SPD) 2020
CVS Caremark Summary Plan Attachment 2020
Flexible Spending Account Summary Plan Description (SPD)
Kaiser HMO N. CA Chiropractic and Acupuncture Evidence of Coverage (EOC) 2021
Kaiser HMO N. CA Evidence of Coverage (EOC) 2021
New York Life: AD&D Certificate 2020
New York Life: Basic Life Certificate 2020
New York Life: Long Term Disability Summary Plan Description (SPD)
New York Life: Supplemental Life Amendment 2020
New York Life: Supplemental Life Certificate 2020
Short Term Disability Summary Plan Description (SPD) 2020
UHC HSA PPO Summary Plan Description (SPD) 2022
UHC Traditional PPO Summary Plan Description (SPD) 2022
Voya Certificate of Coverage Accident Insurance (2021)
Voya Certificate of Coverage Critical Illness (2021)
Voya Certificate of Coverage Hospitalization (2021)
Voya Certificate of Coverage Hospitalization (2023)
VSP Evidence of Coverage (EOC)
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Notices and Documents

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January 6, 2023

Benefit Reminders and Legal Notices

Important action items and legal notifications for your US Benefit plans.

COBRA

Information for workers and their families who have lost their health benefits

Contacts

Complete list of VMware benefits and providers

Health Care Reform

Learn more about the Affordable Care Act and how Health Care Reform impacts you

Intern Benefits

An overview of the US Benefit options available to Paid Interns.

Key Benefit Terms

A glossary of commonly used terms related to your US Benefits.

New Hire Benefits

An overview of the US Benefit options available to New Hires.

Archive: 2023 US Benefits Open Enrollment

Important Benefit Updates for the 2023 plan year, Employee Contributions for health plans, listed enhancements and new services.

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Last Updated: 6 Jan 2023, 3:22 PM

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