Pharmacy
403b and Dade 401k Form Links
Plan Information and Enroll/Change Packets
403(b) Plan Info Packet – Mountain Valley Treatment Center
403(b) Plan Info Packet – Becket Academy
401(k) Plan Info Packet – Dade Family Counseling
Additional Documents
Becket Annual Participant Fee Disclosure
403(b) Enrollment/Change Form
401(k) Enrollment/Change Form – Dade Family Counseling
Health Plan Notices
CHIP Model Notice
CHIP Model Notice (Spanish)
Health Plan Notice Packet
Health Plan Notice Packet (Spanish)
Summary Annual Report (SAR)
Health Insurance Marketplace Coverage Notice
Annual Insurance Coverage Notification
Summary of Benefits and Coverage
Medical
Bronze QHDHP Plan
Silver Plan
Gold Plan
CapitalRx
Welcome Flyer
Welcome Booklet
ACA Medication List
Preventative Medication List
Mail Order Information
Specialty Medication Information
First Stop Health
Telemedicine (ER Steerage)
Telemedicine (Counseling)
Plan Summaries
VSP Vision
Vision Plan
Delta Dental
Base Plan
Buy Up Plan
SunLife
Short-Term Disability
Basic Long-Term Disability
Basic Life Insurance
Accidental Death & Dismemberment (AD&D)
Voluntary Life
Hospital Indemnity
Critical Illness Insurance
Accident Insurance
Moosilauke Visions and Affiliates
Benefit Welfare Plan Summary Plan Description (SPD)