Benefits - United States : Notices and Documents

Archive

2021_RRSP_Tax_receipts_and_slips

2022 Open Enrollment FAQs

ARAG Group Legal Summary

California VMW Voluntary Disability Plan Benefit Rate & Limit Changes 2021

cb028921-815e-4fcc-860b-298f0114b43e

Claim-form

Claims and Preauthorization guidelines

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)

dhig Welcome guide VMware GreeceHealth

dhig Welcome guide VMware GreeceLife

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

Form 1095 Frequently Asked Questions 2021

Grand Rounds Photo

Grand Rounds Photo

Health Care Reform Exchange Notice 2020

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

Manager Tool Kit Leave of Absence Process

Massage Therapy Claim Instructions

Medical Plan Comparison Chart 2020

Medical_Plan_Comparisons

Medical-Plan-Benefits-Guide

Non-Qualified Deferred Compensation Guide 2022

OE Webinars

OE_Landing_Page_Final

Online Benefits Fair Webinars

Online Benefits Fair Webinars

Open Enrollment Important Updates 2022

Pre-authorization-form

pre-FAQ-2022-Open-Enrollment-(final)

PresentationGreece

The Complete HSA Guidebook 13th Edition

TRI-AD Dependent Care FSA Provider Certification Form

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 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

US-CVS-ACA-Preventive-Drug-List

VMware & Included Health How to Guide

VSP Benefit Summary 2020

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

UHC-Preventive-Care-Services-1-1-2020

US Benefits Summary 2020

US-07-2020-PDL-Standard-Control-Advanced-Control-Specialty

US-Benefits-Summary-2020-revised-7.2.20

US-Eyeconic-Overview

VSP Vision Benefit Summary

Compliance Notices

401(k) Summary Annual Report 2019

Annual Compliance Notice 2021

Annual Compliance Notice 2022

COVID 19 Notice of Temporary Summary of Benefit Changes UHC Medical Plans

Drug Free Workplace Policy February 2020

Flexible Spending Account Summary Annual Report 2020

Health and Welfare Summary Annual Report 2020

Health Care Reform_Exchange_Notice_2022

HIPAA Privacy Notice

Medicare Part D Creditable Coverage Notice 2021

Voya Certificate of Coverage D5831 Accident Insurance

Voya Certificate of Coverage D5837 Critical Illness

Voya Certificate of Coverage D5838 Hospitalization

Forms

Adoption-Surrogacy-Reimbursement-form-1.30.2020

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

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

New Hire Notices

401(k) Savings Plan Summary Plan Description (SPD) 2021

Health Care Reform_Exchange_Notice_2022

HIPAA Privacy Notice

Medicare Part D Creditable Coverage Notice 2021

Quick Links

UK AXA – Travel Insurance Handbook

State Specific Notices

2022 California Voluntary Disability Plan Benefit Rate and Limit Changes

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 2022

California VMW Voluntary Disability Plan Summary Plan Document (SPD) 2020

California Workers Compensation Notice

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

Summary of Benefits Coverage

Form 1095C – FAQ 2022 FINAL

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

Summary Plan Descriptions

401(k) Savings Plan Summary Plan Description (SPD) 2021

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

VSP Evidence of Coverage (EOC)

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: 2022 US Benefits Open Enrollment

Important Benefit Updates for 2022, Employee Contribution Increase for Medical plans, Enhancements and increased services to UHC medical, Delta Dental, Progyny and ARAG

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Last Updated: 5 May 2022, 2:33 PM