Benefits Plan Documents and Summaries

 Allegiance (Flex Spending)

Plan Documents
Summary Plan Description

All Employees
2015 Amendment - Med Spend Limit $2,550
2013 Amendment - Med Spend Carryover

The Benefits of a Flex Plan (Video)

All Employees           

 

 Self-Insured PPO

Plan Documents and Summaries

HealthSmart - Medical Claims Administrator
HealthSmart Smart Start Guide
Find a Doctor
Provider not on the AETNA Network?

PPO Informational Meeting Video

WellDyne RX - Prescription Administrator

Vision Service Plan - Vision Administrator
VSP Vision Benefits Summary
Find a VSP Provider

 

 

 Kaiser Medical

Plan Documents
Summary of Benefits and Coverage
2015 HMO (Non Union,AFSCME,Coalition, Police Guild and Command) 2016 HMO (Non Union,AFSCME,Coalition, Police Guild and Command)
2015 CDHP (Non Union,AFSCME,Coalition, Police Guild and Command) 2017 CDHP (Non Union,AFSCME,Coalition, Police Guild and Command)
 
Benefit Summaries
Kaiser Guide to Preventive Services 2015 HMO (Non Union,AFSCME,Coalition, Police Guild and Command)
  2015 CDHP (Non Union,AFSCME,Coalition, Police Guild and Command)

 Kaiser Dental

Plan Documents
Benefit Summaries
2015 Kaiser Dental (Non Union, AFSCME, Coalition, Police Guild and Command) 2016 Kaiser Dental (Non Union, AFSCME, Coalition, Police Guild and Command)


 Delta Dental of Washington (Washington Dental Service)

Plan Documents
Benefit Summaries
2015 Non Union-596 2015 Non Union-596
2015 Non Union-596 w/Buy-up 2015 Non Union-596 w/Buy-up
2015 Union-854 (AFSCME,Coalition,Police Guild and Command) 2015 Union-854 (AFSCME,Coalition,Police Guild and Command)
2015 Union-854 w/Buy-up (AF,Coalition, Police Guild and Command) 2015 Union-854 w/Buy-up (AF,Coalition, Police Guild and Command)

 

 Cigna - Life and Long Term Disability (formerly Standard)

Non Union
AFSCME, Coalition and OPEIU
Fire Command

 

Police Guild (Life and AD&D only)
Police Command (Life and AD&D only)  
Fire Suppression (Life and AD&D only)
Fire Marshals Office (Life and AD&D only)

 Cigna - Short Term Disability (OPEIU Only)

Summary
Certificate of Coverage

How to File A Claim

 

 Retirement Health Savings (RHS)

This plan is closed to new enrollees.  Contact Benefits Staff for documents and forms.

   
 LEOFF 1 Retirees and Dependents

 
 HIPAA Privacy Notices

COV Health Care Benefit Program Kaiser Permanente
Delta Dental of Washington Cigna Corporation and  its Affiliates
   

For Additional information, please contact a Human Resources Total Compensation Team member at (360) 487-8414.