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.
Summary Plan Descriptions (SPD)
Medical Summary Plan Descriptions
- Open Access Plus (OAP) - 2022
- Cigna Choice Fund (CCF) - 2022
- HDHP with Health Reimbursement Account (HRA) - 2022
- HDHP with Health Savings Account (HSA) - 2022
- Dartmouth College Medicare Supplement Plan (DCMS) - 2022
Dental Summary Plan Description
Disability Summary Plan Descriptions
- Disability Plan through Lincoln Financial (All Faculty, Exempt, Non-Exempt and Research Associate B's receiving STD or LTD pay on or after 1/1/18)
- Disability Plan through Liberty Mutual (All SEIU Union Members receiving STD or LTD pay on or after 1/1/18)
- Disability Plan through Matrix (All disabled employee's receiving LTD pay prior to 1/1/18)
Summary Annual Reports (SAR)
Other Legal Notices
- Creditable Prescription Drug Coverage Notice - A legal requirement notice for those who are eligible for Medicare.
- Children's Health Insurance Program (CHIP) - An assistance program for children who are eligible for Medicaid.
- Notice of Privacy Practice
- Patient Protection Disclosure
- Women's Health in Cancer Rights Notice
- Marketplace Notice - This notice informs you of your rights to seek health insurance coverage on the Marketplace.
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