Required Legal Documents

Summary of Benefits and Costs (SBC)

In accordance with The Patient Protection and Affordable Care Act (also known as Federal Health Care Reform), all benefits eligible employees are required to receive a Summary of Benefits and Coverage (SBC) for your medical plan options. The SBC is produced by Cigna in accordance with federal guidelines and designed to help you understand and evaluate your medical plan choices. The federal law requires that you have access to the SBC for your current benefit year. Since Dartmouth offers more than one Cigna medical plan option, you are able to view SBCs for each option below. 

CIGNA MEDICAL SBC

Summary of Benefits (SoB)

A Summary of Benefits is a plain language document that outlines the key features, costs, and coverage details of a health insurance plan.

CIGNA MEDICAL SoB

 

EXPRESS SCRIPTS PHARMACY SoB

 

Summary Plan Descriptions (SPD)

A Summary Plan Description is a legal document mandated by ERISA and is a plain-languge document that explains the details of your health benefits, covering eligibility, costs (deductibles, copays, coinsurance), covered services, exclusions, how to file claims and your rights. 

CIGNA MEDICAL SPD

DELTA DENTAL SPD

LINCOLN FINANCIAL DISABILITY SPD

Summary Annual Reports (SAR)

Summary of Material Modification (SMM)

Qualified Default Investment Alternative (QDIA) Notice

Other Legal Notices

 

 

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