Plan Documents and Legal Notices

Medical Documents

2025–2026 Anthem Fee-for-Service PPO (Retirees Age 65 or Over) Summary of Benefits and Coverage

2025–2026 Anthem Fee-for-Service PPO (Retirees Age 65 or Over) Benefit Summary

2025–2026 Anthem Fee-for-Service PPO + Prescription (Retirees Age 65 or Over) Summary of Benefits and Coverage

2025–2026 Anthem Fee-for-Service PPO + Prescription (Retirees Age 65 or Over) Benefit Summary

2025–2026 Anthem Custom Premier PPO Summary of Benefits and Coverage

2025–2026 Anthem Custom Premier PPO Benefit Summary

2025–2026 Anthem Custom Premier PPO + Prescription Summary of Benefits and Coverage

2025–2026 Anthem Custom Premier PPO + Prescription Benefit Summary

2025–2026 Anthem Custom BC Premier PPO Summary of Benefits and Coverage

2025–2026 Anthem Custom BC Premier PPO Benefit Summary

2025–2026 Anthem Custom BC Premier PPO + Prescription Summary of Benefits and Coverage

2025–2026 Anthem Custom BC Premier PPO + Prescription Benefit Summary

2025 Kaiser Senior Advantage HMO Plan + Medicare Part D Prescription Summary of Benefits

2025 Kaiser Traditional HMO, Deductible HMO and HSA-Qualified HDHP HMO Disclosure Form / Evidence of Coverage

2025 Kaiser Traditional HMO, Deductible HMO and HSA-Qualified HDHP HMO Benefit Summary

2025 Kaiser Traditional HMO Disclosure Form

Dental Documents

Delta Dental of California Evidence of Coverage & Disclosure Form

2024 Delta Dental PPO Benefit Summary

2024 Delta Dental PPO & Delta Care Benefit Summary

Vision Documents

2025 VSP Vision Signature Plan Summary

Life Insurance Documents

Life Insurance Summary

Compliance Notices

See your Benefits Booklet