Plan Documents

Annual Notices:

• Crowd Street SAR

Aetna:

• 
  Member Letter

• Certificate Booklet

• Aetna OAMC PPO 500 Certificate of Coverage
• Aetna OAMC PPO 500 Schedule of Benefits

• Aetna OC PPO 500 Certificate of Coverage
• Aetna OC PPO 500 Schedule of Benefits

• Aetna OAMC PPO 2000 Certificate of Coverage
• Aetna OAMC PPO 2000 Schedule of Benefits

• Aetna OC PPO 2000 Certificate of Coverage
• Aetna OC PPO 2000 Schedule of Benefits

• Aetna OAMC HDHP 2800 Certificate of Coverage
• Aetna OAMC HDHP 2800 Schedule of Benefits

• Aetna OC HDHP 2800 Certificate of Coverage
• Aetna OC HDHP 2800 Schedule of Benefits

• Aetna Rider Document

• Montana OAMC Rider
• Montana OAMC HDHP Rider
• Washington OAMC Rider
• Washington OAMC HDHP Rider

Guardian Dental:

• 2022 Certificate Booklet

Guardian Dental:

• 2022 Certificate Booklet

Guardian Life and Disability:

• 2022 Certificate Booklet

Plan Documents


Aetna:

• Aetna OAMC 500 SBC
• Aetna PPO 500 SBC
• Aetna OAMC 500 Summary
• Aetna PPO 500 Summary

• Aetna OAMC 2000 SBC
• Aetna PPO 2000 SBC
• Aetna OAMC 2000 Summary
• Aetna PPO 2000 Summary

• Aetna OAMC HDHP 3000 SBC
• Aetna PPO HDHP 3000 SBC
• Aetna OAMC HDHP 3000 Summary
• Aetna PPO HDHP 3000 Summary

• Member Letter

• Aetna OAMC Certificate of Coverage
• Aetna OAMC Schedule of Benefits

• Aetna OC PPO Certificate of Coverage
• Aetna OC PPO 500 Schedule of Benefits
• Aetna OC PPO 2000 Schedule of Benefits

• Aetna OAMC HDHP Certificate of Coverage
• Aetna OAMC HDHP Schedule of Benefits

• Aetna OC HDHP Certificate of Coverage
• Aetna OC HDHP Schedule of Benefits

• Aetna OAMC - Physician and Specialist Surgical services paid differently - Certificate of Coverage
• Aetna OAMC - Physician and Specialist Surgical services paid differently - Schedule of Benefits

• Aetna Plain Language Open Access Managed Choice Extraterritorial Riders
• Aetna Plain Language Open Access Managed Choice High Deductible Health Plan Extraterritorial Riders
• Aetna Plain Language Open Access Managed Choice Extraterritorial Riders - Physician and Specialist Surgical services paid differently

• Montana OC Rider
• Montana OC HDHP Rider
• Missouri OC Rider
• Maine OAMC HDHP Rider Amendment
• Maine OAMC PPO Rider Amendment

• Aetna Addendum - Medical Tagline

Guardian Dental:

• Dental Core/Buy-Up Summary

• 2022 Certificate Booklet

Guardian VSP Vision:

• Guardian Vision Plan Summary

• 2022 Certificate Booklet

Guardian Life and Disability:

• Basic/Vol Life and AD&D Summary
• 2022 Certificate Booklet
• STD & LTD Plan Summary
• 2022 Certificate Booklet

Guardian Voluntary Accident and Critical Illness:

• Accident Summary
• Critical Illness Summary
• 2022 Certificate Booklet

Compliance

• 2023 Medicare Part D Notice of Creditable Coverage
• 2023 Children’s Health Insurance Program (CHIP) Notice
• 2023 Notice of HIPAA Enrollment Rights
• 2023 Women’s Health and Cancer Rights Act (WHCRA) Notice
• 2023 ADA Notice Regarding Wellness Program
• 2023 ACA Marketplace Notice
• Covid-19 SMM - End of Emergency Period

Plan Documents


Aetna:

• Aetna OAMC 500 Summary
• Aetna OAMC 500 SBC
  
  
• Aetna PPO 500 Summary
• Aetna PPO 500 SBC
• Aetna OAMC 2000 Summary
• Aetna OAMC 2000 SBC
  
  
• Aetna PPO 2000 Summary
• Aetna PPO 2000 SBC
• Aetna OAMC HDHP 3200 Summary
• Aetna OAMC HDHP 3200 SBC
  
  
• Aetna PPO HDHP 3200 Summary
• Aetna PPO HDHP 3200 SBC

Aetna Resources

• Aetna Member Flyer
• Aetna Health App
• Aetna Maternity Program
• 24 Hour Nurse Line Member Flyer
• Behavioral Health
• Telehealth Services
• Talkspace
• Teladoc Mental Health

Guardian Dental:

• Dental Core/Buy-Up Summary

• 2022 Certificate Booklet

Guardian VSP Vision:

• Guardian Vision Plan Summary

• 2022 Certificate Booklet

Guardian Life and Disability:

• Basic/Vol Life and AD&D Summary
• 2022 Certificate Booklet
• STD & LTD Plan Summary
• 2022 Certificate Booklet

Guardian Voluntary Accident and Critical Illness:

• Accident Summary
• Critical Illness Summary
• 2022 Certificate Booklet

Compliance

• 2024 Medicare Part D Notice of Creditable Coverage
• 2024 Children’s Health Insurance Program (CHIP) Notice
• 2024 Women’s Health and Cancer Rights Act (WHCRA) Notice
• 2024 Notice of HIPAA Enrollment Rights
• 2024 Patient Protections Notice
• 2024 ADA Notice Regarding Wellness Program
• 2024 ACA Marketplace Notice
• Covid-19 SMM - End of Emergency Period