Documents & Forms
Plan Documents
Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC) documents provide detailed information about the plans provided under the Employment Retirement Income Security Act of 1974. They contain the plan administrator’s identity, requirements for eligibility and participation in the plan, circumstances that may result in disqualification or denial of benefits, and the identity of insurers.
Medical
Summary Plan Description (SPD)
NON-REPRESENTED EMPLOYEES
Johns Hopkins EPO Plan + Short-term Disability SPD
Johns Hopkins PPO Plan + Short-term Disability SPD
Johns Hopkins DPC Plan + Short-term Disability SPD
REPRESENTED EMPLOYEES
Johns Hopkins EPO Plan + Short-term Disability SPD
Johns Hopkins PPO Plan + Short-term Disability SPD
Johns Hopkins DPC Plan + Short-term Disability SPD
Summary of Material Modifications (SMM)
NON-REPRESENTED EMPLOYEES
SMM for Johns Hopkins EHP Plans + Short-Term Disability SPD
REPRESENTED EMPLOYEES
SMM for Johns Hopkins EHP Plans + Short-Term Disability SPD
Summary of Benefits and Coverage (SBC)
Johns Hopkins PPO Plan SBCs:
Johns Hopkins DPC Plan SBCs:
Life Insurance Certificates
Disability
Compliance Notices
Medicare Part D Creditable Coverage Notice
Notice of Privacy Practices for Health Plans
HIPAA Notice of Privacy Practices for Superior Vision Plan
HIPAA Notice of Privacy Practices for EHP Health Plans
HIPAA Notice of Privacy Practices for Delta Dental Plans
