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Legal Notices and Plan Documents
Please see below for notices related to your healthcare and benefits provided by T&M.
Special Enrollments Rights, Marketplace information, Women's Health & Cancer Rights, and CHIP Notices
(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_a5bf48e6ce6d4dd4b07472e009cdc4fd.pdf)
Your Rights and Protections Against Surprise Medical Bills(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_a099eca7b6e14953a16cb86d2e18d264.pdf)
HIPAA Privacy Notice
(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_c6031cf09df54a8a96ace239e58837b8.pdf)
High Deductible with HSA Plan - Summary of Benefits & Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_07880ed825934bd5831efd8f36b202e0.pdf)
Core EPO Plan - Summary of Benefits & Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_4628063d3acf47b0bf0d80e9ccd046e3.pdf)
Open Access Plan - Summary of Benefits & Coverage
(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_089a897569b843c2b8aef3d8d27ed131.pdf)
Medical Benefits Summary(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_5cc570507e0c4522a1851c8457eca697.pdf)
Employer Welfare Plan (Wrap Document)
(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_d866d870b6c44ad9af9ea3f36c4e6cf5.pdf)
PPO Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_48f5d8b110a24eaba15ee91c81e08b1a.pdf)
PPO + Premier Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_8f876e8c7dcc4f2c8fbc7865a5283dbd.pdf)
PPO Plan Summary of Benefits and Coverage (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_cce6d9f86c4b427fadb1ffb651b43e01.pdf)
PPO Plan Summary Booklet (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_db7eeea598fe46289c1bb16bf5e06b2c.pdf)
PPO + Premier Plan Summary Booklet (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_c1807ab8eb7a4d2bba623d643094d580.pdf)
Enhanced PPO + Premier Plan Summary Booklet (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_5b2683709e12464691cf338d2e2ffc93.pdf)
Benefits Summary (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_b71803ab6dbf45e1b47989e01858dbbf.pdf)
Summary Plan Description (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_35dca78781c743a49b8a883840b164c5.pdf)
Summary of Material Modifications - Changes in Hardship Distribution Rules(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_030b38669a70489a94dc24d50bcc788d.pdf)
Summary of Material Modifications - In-Plan Roth Transfers(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_22031686468348edbd33821b95aecbeb.pdf)
Summary of Material Modifications 2024 (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_21a6ffc7fae64605aa0a7c3d68257980.pdf)
Investment Changes as of May 2022(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_94c1a342626f4dc480417e101c8a6783.pdf)
Automatic Deferral Notice(https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_36c56c64b7564eb49c2b73be0a0b3714.pdf)
Amendment to Services Agreement (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_c1e35663785e4d169ad95aeb02b0f8a0.pdf)
Medicare creditable coverage disclosure notice (https://51ffe31a-367e-4d24-aee7-bc3a6db21df6.usrfiles.com/ugd/51ffe3_9c12c91f743044fe91d1f8edc39af8c6.pdf)
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