Plan documents and forms

Benefits

2023 PayPal Benefits Overview
Health and Welfare Benefits Summary Plan Document

Notices

401(k) Safe Harbor Notice
401(k) Summary Annual Report
Health and Welfare Summary Annual Report
Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice
Newborns’ and Mothers’ Health Protection Act Notice
Notice of Special Enrollment Rights for Health Plan Coverage
Provider-Choice Rights Notice
Women's Health and Cancer Rights Act (WHCRA) Notice

Health — Accolade Care Support

Accolade FAQ
Accolade Healthcare Experience
Activation Guide
Autism Support
Care and Condition Support
Emotional and Mental Health Support
Gender Affirming Care Guide
Inclusive Care
Virtual Care

Health — Medical

2023 Meritain CDHP with HSA SBC
2023 Meritain CDHP with HSA SPD
2023 Meritain Copay Plan SBC
2023 Meritain Copay Plan SPD
2023 Meritain Copay Plan with HRA SBC
2023 Meritain Copay Plan with HRA SPD
2023 Meritain Health Medical Plan Comparison Chart
2024 Meritain CDHP with HSA SBC
2024 Meritain Copay Plan SBC
2024 Meritain Copay Plan with HRA SBC
How to Download a Labcorp Voucher
How to request a Labcorp OnDemand™ home test kit
How to Schedule Screening Appointment
Labcorp FAQs
Meritain & Accolade Transition of Care
Meritain Explanation of Benefits (EOB)
Meritain Health Covered Preventive Care Services
Meritain Health Out-of-Network Claims Submission Process
Meritain – Aetna Network Provider Nomination Form

Health — Kaiser Medical

2023 Kaiser Evidence of Coverage (N. CA)
2023 Kaiser Evidence of Coverage (S. CA)
2023 Kaiser HMO Benefit Summary (S. CA)
2023 Kaiser HMO Benefits Summary (N. CA)
2023 Kaiser HMO SBC (N. CA)
2023 Kaiser HMO SBC (S. CA)
2024 Kaiser Evidence of Coverage (N. CA)
2024 Kaiser Evidence of Coverage (S. CA)
2024 Kaiser HMO Benefit Summary (N. CA)
2024 Kaiser HMO Benefit Summary (S. CA)
2024 Kaiser HMO SBC (N. CA)
2024 Kaiser HMO SBC (S. CA)
Kaiser Chiropractic Services
Kaiser Permanente: Video Visits
Kaiser Permanente: Your Care, Your Way
Kaiser Video Visit Instructions

Health — HMSA

2023 HMSA Hawaii SBC
2024 HMSA Dental Benefits Guide
2024 HMSA Hawaii SBC
2024 HMSA Medical Benefits Guide
2024 HMSA Prescription Drug Certificate
2024 HMSA Vision Benefits Guide
HMSA Hawaii Enrollment Form

Health — Prescription Drugs

2023 CVS Advanced Control Speciality Formulary List – July
2023 CVS Performance Drug List – July
2024 CVS Pharmacy CDHP Summary
2024 CVS Pharmacy Copay Summary
CVS Claim Form
CVS Pharmacy CDHP Summary
CVS Pharmacy Copay Summary
CVS Prior Authorization Form
CVS Prior Authorizations Overview
CVS Prior Authorizations, Exceptions, and Appeals Programs

Health — Dental

Delta Dental Benefit Summary
Delta Dental Core Plan
Delta Dental Enhanced Plan
Delta Dental Evidence of Coverage

Health — Vision

VSP Benefit Summary
VSP Evidence of Coverage
VSP Out-of-Network Reimbursement Form
VSP SPD

Emotional wellbeing

EAP Arbor (NE)
EAP Optum
Optum Counseling Concierge Services
Optum Telemental Health FAQ
Optum Virtual Visits
Wellness Support Resources

Financial security — Life and disability

Basic Accidental Death & Dismemberment Benefits Summary
Basic and Optional Life Benefits Summary
Prudential Term Life Policy
Short-term disability Summary Plan Description (SPD)
Supplemental Accidental Death and Dismemberment Summary
Voluntary Accidental Death & Dismemberment Summary

Financial security — Retirement

2023 401(k) Guide
401(k) Payroll Cut-off Dates 2023
401(k) Rollover Form
401(k) Summary Plan Description (SPD)
Information for non-resident Visa holders
Schwab Pre-Retirement Playbook

Financial security — Voluntary benefits

Aflac Group Accident Insurance
Aflac Group Critical Illness
Aflac Group Hospital Indemnity

Financial security — Other financial documents

FSA administrator change FAQs
Health Care and Dependent Care FSA FAQs
HRA Plan SPD
Hyatt Legal Plans
Optum's Core ID Identity Theft Protection
Spending Accounts SPD

Time away

2023 PayPal CVP Plan Document
2023 PayPal CVP Plan Updates
2023 PayPal CVP Supplement to Plan Amendment
Prudential Long-Term Disability Summary

Family support

Child and Elder Care Resources (Bright Horizons)
Family Support Benefits (Bright Horizons)
Family Support Registration Guide (Bright Horizons)