Plan Documents and Legal Notices

Plan Documents

2025

Voya – Accident Insurance Plan Summary
Voya – Accident Insurance Certificate of Coverage
Voya – How To File A Claim
Voya – How To Identify Claims Opportunities

2025

Lennox – Adoption Reimbursement Program
Lennox – Adoption Reimbursement Form

2025

Voya – Critical Illness Insurance Plan Summary
Voya – Critical Illness Insurance Certificate of Coverage
Voya – Critical Illness Insurance $100 Wellness Benefit
Voya – Critical Illness Attending Physician Statement
Voya – How To File A Claim
Voya – How To Identify Claims Opportunities

2025

Delta Dental – Benefit Summary
Delta Dental – Evidence of Coverage

2025

EAP Evidence of Coverage

2025

TaxSaver – 2025 FSA Benefit Summary
TaxSaver – Standard FSA Claim Form
Lennox – FSA Flex Debit Card Information

2025

Sedgwick – Short-Term Disability SPD (Salaried)
Sedgwick – Short-Term Disability SPD (Hourly)

New York Life – Long-Term Disability Benefit Summary (Salaried)
New York Life – Long-Term Disability SPD (Salaried)

New York Life – Long-Term Disability Benefit Summary (Hourly)
New York Life – Long-Term Disability SPD (Hourly)

2025

Voya – Life and AD&D Certificate of Coverage
Voya – How To File A Claim

2025

UMR – 2025 Green Plan Benefits Summary
UMR – 2025 Blue Plan Benefits Summary
Lennox – 2025 Tobacco Use Affidavit
Lennox – 2025 Working Spouse Affidavit

2024

UMR – 2024 Green Medical Plan SPD
UMR – 2024 Blue Medical Plan SPD

2025

Lennox – Volunteer Time Off Benefit
Lennox – Well-Being Time Off Benefit

2025

OptumRx – 2025 Premium Standard Formulary List
OptumRx – 2025 Premium Standard Formulary List (Preventive Generics)
OptumRx – 2025 Premium Standard Formulary List (PA Required)
OptumRx – 2025 Premium Standard Formulary List (Quantity Limits)
OptumRx – 2025 Premium Standard Formulary List (Step Therapy)
OptumRx – 2025 Premium Formulary Exclusion List

2025

Lennox – Tuition Assistance Program Summary
Lennox – University of Phoenix Partnership FAQs

2025

EyeMed – Vision Benefit Summary (English)
EyeMed – Vision Benefit Summary (Spanish)

Legal Notices

2025 Required Notices – All Active Employees
2025 Wellness Notice
2025 CHIP Notice
2025 Health Insurance Marketplace Notice
2025 Medicare Part D – Women’s Health and Cancer Rights
2025 State of Illinois Essential Health Benefit Listing
Your Rights and Protections Against Surprise Medical Bills