Documents and forms

Documents and forms State-mandated notices

Benefit documents

2024 Benefits Guide
2024 Total Rewards Overview
2025 Benefits Guide
2025 Benefits Plan Comparison
Domestic Partnership Certification Form
Group Welfare Plan and Summary Plan Description
HIPAA Authorization for Release of Information

Health and wellness—UnitedHealthcare (UHC) medical

2024 SBC - UHC Choice Plan (EPO)
2024 SBC - UHC Choice Plus Expanded Access (Out of Area) PPO Plan
2024 SBC - UHC Choice Plus High Deductible Plan
2024 SBC - UHC PPO Choice Plus Plan (PPO)
2024 SBC - UHC PPO Hawaii
2024 SPD - UHC Choice Plan (EPO)
2024 SPD - UHC Choice Plus Expanded Access (Out of Area) PPO Plan
2024 SPD - UHC Choice Plus High Deductible Plan
2024 SPD - UHC Choice Plus Plan (PPO)
2024 SPD - UHC Options PPO Plan (Hawaii Only)
2025 SBC - UHC Choice Plan (EPO)
2025 SBC - UHC Choice Plus Expanded Access (Out of Area) PPO Plan
2025 SBC - UHC Choice Plus High Deductible Plan
2025 SBC - UHC PPO Choice Plus Plan (PPO)

Health and wellness—Kaiser medical

2024 EOC - Kaiser Northern California
2024 EOC - Kaiser Northern California Chiropractic Services
2024 EOC - Kaiser Northern California Pier 9
2024 EOC - Kaiser Oregon
2024 EOC - Kaiser Southern California
2024 EOC - Kaiser Southern California Chiropractic Services
2024 SBC - Kaiser California
2024 SBC - Kaiser California Pier 9
2024 SBC - Kaiser Oregon
2025 SBC - Kaiser California
2025 SBC - Kaiser California Pier 9
2025 SBC - Kaiser Oregon

Health and wellness—Dental

2024 Summary - Aetna Dental DMO Plan
2024 Summary - Aetna Dental PPO Plan
2025 SBC - Aetna Dental DMO Plan
Aetna Dental DMO Plan Booklet
Aetna Dental DMO Plan Booklet (Arizona)
Aetna Dental DMO Plan Booklet (California)
Aetna Dental DMO Plan Booklet (New Jersey)
Aetna Dental DMO Plan Booklet (North Carolina)
Aetna Dental DMO Plan Booklet (Texas)
Aetna Dental PPO Plan Booklet

Health and wellness—Vision

2024 Summary - VSP Basic and Plus Plans
VSP Group Vision Care Plan EOC

Health and wellness—FSA and HSA

Health Savings Account (HSA) vs. Health Care Flexible Spending Account (FSA) FAQ
Optum Bank Health Savings Account (HSA) Midyear Change Guidelines
Optum Bank Health Savings Account (HSA) User Guide
Optum Bank terms and conditions

Health and wellness—Cigna global medical plan

2024 SBC - Cigna Global Plan
SPD - Cigna Global Plan

Financial

Lincoln Life and AD&D (Basic) Coverage Summary 
Lincoln Life and AD&D (Optional) Coverage Summary
Lincoln Life and AD&D Certificate of Coverage
Lincoln Long-Term Disability (LTD) Certificate of Coverage
Lincoln Long-Term Disability (LTD) Coverage Summary
Long-Term Disability (LTD) – Taxable Payout Agreement
State Disability: California Voluntary Disability Insurance (VDI)
State Disability: Hawaii
State Disability: New York

Time away

Discretionary Time Off (DTO) Philosophy and Q&A
Discretionary Time Off (DTO) Policy
Leave Policies
Sabbatical Policy
Vacation Policy

Everyday living

ARAG Legal Insurance Certificate and Service Plan
Commuter Check enrollment
Make a Family Claim Form

Legally required documents and notices

Cafeteria Plan with Flexible Spending Arrangement
Children’s Health Insurance Plan (CHIP) Notice
Federal Women’s Health and Cancer Rights Act of 1998
Group Welfare Plan Summary Annual Report (2023)
Health Insurance Marketplace Notice
HIPAA Notice of Special Enrollment
HIPAA Privacy Notice
Medicare Part D Notice of Creditable Coverage (2024-25)
Rights & Responsibilities under the Family and Medical Leave Act