Plan Documents

Below is a list of insurance carrier documents, including coverage detail summaries, certificates of coverage and policies. Click the link to view or print the document for the plan(s) you are currently enrolled in.

Please note: The attached documents are not a guarantee of current or future coverage. If you have specific questions regarding these documents or your coverage, please contact the insurance carrier directly.

Medical and Prescription Drug Plan

Blue Cross Blue Shield of Arizona Plan Document and Summary Plan Description

Plan Amendment and SMM to Self-Funded Medical & Prescription Plan

Dental Plan

Delta Dental Value Plan Certificate

Delta Dental Core Plan Certificate

Delta Dental Premium Plan Certificate

Vision Plan

VSP Benefits Summary

Kaiser Permanente

Kaiser Permanente CA Summary of Benefits

Supplemental and Voluntary Benefits

Accident Insurance Certificate

Critical Illness Certificate

Hospital Indemnity Certificate

Life Insurance and Accidental Death and Dismemberment Certificate-Class-1-Drivers

Life Insurance and Accidental Death and Dismemberment Certificate-Class-2-Hourly-NonDrivers

Life Insurance and Accidental Death and Dismemberment Certificate-Class-3-Salaried-NonDrivers

Life Insurance and Accidental Death and Dismemberment Certificate-Class-4

Long-Term Disability Certificate-1100-Option

Long-Term Disability Certificate-1800-Option

Long-Term Disability Certificate-2500-Option

Long-Term Disability Certificate-3500-Option

Long-Term Disability Certificate-5000-Option

Long-Term Disability Certificate-7500-Option

Long-Term Disability Certificate-10000-Option

Short-Term Disability Certificate-250-Option

Short-Term Disability Certificate-400-Option

Short-Term Disability Certificate-550-Option

Short-Term Disability Certificate-750-Option

Short-Term Disability Certificate-1000-Option