Plan Docs & Forms
Cigna Scripps Select HMO Plan
- Summary of Benefits and Coverage (SBC)
- Benefit Summary
- FHCSD Cigna Medical HMO Select Network
- Scripps HealthExpress
- Scripps HealthExpress Locations
Cigna Full HMO Plan
Kaiser Permanente Deductible HMO Plan
SIMNSA HMO Plan
- Summary of Benefits and Coverage (SBC)
- Benefits and Schedule of Copayments
- Benefits and Schedule of Copayments (Spanish)
- FHCSD SIMNSA Medical HMO
Cigna OAP PPO Plan
Cigna Additional Resources
- 2024 Cigna Healthcare Pharmacy Clinical Update
- Cigna Toolkit
- Scripps Select Know Before You Go
- Scripps Select Know Before You Go (Spanish)
- Virtual Behavioral Health Care Program
Kaiser Permanente Additional Resources
Cigna DHMO Plan
Cigna DPPO Plan
SIMNSA DHMO Plan
VSP Vision Plan
- Plan Summary
- VSP Notice of Privacy Practices
- Annual DMHC Complaints and Grievance Member Notification
Cigna Medical- Vision Exam Benefit
FSA
- Flexible Savings Account SPD
- FSA – Account Overview
- FSA – Medical Care Worksheet
- FSA – Eligible Products List
- FSA – Dependent Care Worksheet
- FSA – Claim Form Dependent Care Reimbursement
- FSA – Dependent Care Reimbursement Eligibility Expense List
- FSA – Dependent Care Reimbursement Account Overview
- FSA – Claim Form Medical Reimbursement
- Igoe Mobie App User Guide
- Benefits Card – Information
- Dependent Care Reimbursement Account Overview Flyer
- Dependent Care Reimbursement Eligibility Expense List
- Dependent Care Worksheet
- Dependent Day Care Provider Acknowledgement
- Flexible Benefits Card Additional Cardholder Request Form
- Flexible Spending Account Overview Flyer
- FSA Reimbursement Request Form
- FSA Rollover 550 Consumer Flyer
- Medical Care Worksheet
- OTC and Telehealth
- Understanding Carryover
- Understanding Grace Period
Unum Basic Life and AD&D Insurance
Unum Voluntary Life
Additional Resources
Unum Short-Term Disability
Unum Long-Term Disability
Accident Insurance
Critical Illness Insurance
Hospital Indemnity Insurance
Term Life
Voluntary Short-Term Disability
Retirement Plans
- 403 (b) 4-46501 SPD
- 403 (b) 446501 Enrollment Workbook
- 403 (b) SMM 1-1-2018
- FHCSD 457(b) 610033 Distribution Choices Guide
- FHCSD 457(b) 610033 Enrollment Workbook
Pet Insurance
Travel Assistance
FHCSD Wellness Program
Concern EAP
- Parenting and Child Care
- Retirement Lifestyle Planning
- Counseling Services
- Financial Services
- ID Theft Response Services
- Legal Referral Services
“LevelUP in 2024”
- Together Movement
- Banksy’s Best
- Life Adviser Special Edition: Tips for Telecommuting
- Life Adviser Special Edition: COVID-19 Update
- Life Adviser Special Edition: Social Distancing
- Life Adviser Special Edition: Managing Fear and Anxiety around Coronavirus
Videos
- World Health Organization (WHO) Novel Coronavirus
- World Health Organization (WHO) – How to protect yourself against COVID-19
CDC Resources
CDC Resources – Spanish
Cigna Resources
Cigna Resources – Spanish
Kaiser Resources
Legal Notices
Click here to access the following notices:
- Medicare Part D Creditable Coverage Notice
- CHIPRA/CHIP Notice
- Women’s Health and Cancer Rights Act
- Wellness Program Disclosure
- HIPAA Notice of Privacy Practices
- Patient Protection Disclosures
- ACA Section 1557 Nondiscrimination Notice and Taglines
- Notice of Marketplace Coverage Options
- Notice of Special Enrollment Rights
