Library

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Alaska Region

Alaska

Alaska SPD: English | Spanish
SBCs

Bronze Plan: English | Spanish
Silver Plan: English | Spanish
Gold Plan: English | Spanish

SMMs

Atlantic City Region

Atlantic City - Casinos

Atlantic City - Non-Casinos

Pittsburgh

Boston Region

Boston Area

SPD
SBC
SMMs

Chicago Midwest Region

Chicago Hotels

SPD
SBC
SMMs

Chicago Sporting Events

SPD
SBC
SMMs

Chicago Restaurants

SPD
SBC
SMMs

Detroit

Midwest Casino

California Region

Long Beach/Orange County

SPD: English - Español
Wrap SPDs

Kaiser LB/OC: English | Español
Liberty DHMO
Liberty Dental LDP-100: English | Español
Liberty UHH PPO Schedule: English | Español

SBCs

SBC 462
Kaiser HMO only
Kaiser HMO with Liberty dental benefits and/or UnitedHealthcare vision benefits

SMMs

2022 – February
2021 – Annual Welfare SMM
2021 – September
2021 – August
2021 – April (Eligibility)
2021 – April (Dental/Medical)
2021 – COVID-19 SMM
2021 – January
2020 – Annual Welfare SMM
2020 – September
2020 – July
2019 – December
2019 – Annual Welfare SMM
2019 – April
2019 – March
2018 – Annual Welfare SMM
2018 – October
2018 – March
2017 – December
2017 – Annual Welfare SMM
2017 – July

Los Angeles

SPD: English - Spanish
Wrap SPDs

Kaiser+ (DHMO): English | Español
Kaiser++: English | Español
Kaiser+++: English | Español

Dental DHMO:

Get your dental HMO EOC from Delta at www.deltadentalins.com/deltacare or by calling (800) 422-4234.
Please disregard the Eligibility and Termination sections in the EOC—the Fund determines who is eligible.

SBC: Kaiser+ - Kaiser++ - Kaiser+++ - PPO
SMMs

2022 – June
2022 – February
2022 – February (Kaiser)
2021 – November
2021 – Annual Welfare SMM
2021 – September
2021 – August
2021 – April (Eligibility/Prescription Drug)
2021 – April (Dental/Medical)
2021 – COVID-19 SMM
2021 – January
2020 – Annual Welfare SMM
2020 – September
2020 – July
2019 – December
2019 – Annual Welfare SMM
2019 – October
2019 – April
2019 – March
2018 – Annual Welfare SMM
2018 – October

Monterey Culinary Health Plan

New York Region

New York Plan

SPD: Plan A - Plan B
SBC: Plan A - Plan B
SMMs

2022 – June (Protection from unexpected medical costs)
2022 – June (Fund Centers of Excellence)
2022 - February
2021 - December
2021 – November
2021 – Annual Welfare SMM
2021 – September
2021 – August
2021 – April
2021 – COVID-19 SMM
2021 – January
2020 – Annual Welfare SMM
2020 – September
2020 – July
2020 – March: Plan A - Plan B
2019 – December
2019 – Annual Welfare SMM
2019 – October
2019 – March
2018 – Annual Welfare SMM
2018 – October
2017 – December

Greater New York Regional Hotel Plan

SPD
SBC
SMMs

2022 – June (Protection from unexpected medical costs)
2022 – June (Fund Centers of Excellence)
2022 - February
2021 - December
2021 – November
2021 – Annual Welfare SMM
2021 – September
2021 – August
2021 – April
2021 – COVID-19 SMM
2021 – January
2020 – Annual Welfare SMM
2020 – September
2020 – July
2020 – March
2019 – December
2019 – Annual Welfare SMM
2019 – October
2019 – March
2018 – Annual Welfare SMM
2018 – October
2017 – December

National Plans

Food Service Plan

SPD
Wrap SPDs
Medical

Kaiser California: Kaiser++ (English) | Kaiser++ (Español), Northern California (English) | Northern California (Español)
Kaiser Colorado
Kaiser Georgia
Kaiser Mid-Atlantic: Signature, Select Low, Select High

Dental

Delta Dental HMO: Get your dental HMO EOC from Delta at www.deltadentalins.com/deltacare or by calling (800) 422-4234.
Please disregard the Eligibility and Termination sections in the EOC—the Fund determines who is eligible.

SMMs

2022 – June (Protection from unexpected medical costs)
2022 – June (Fund Centers of Excellence)
2022 - February
2022 - February (Kaiser)
2021 – December (Fort Benning only)

Food Service Plan SBCs

Platinum+

SBC 468:
- Platinum+ medical benefits only
- Platinum+ medical benefits with VSP vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 469:
- Platinum+ medical benefits with 24-month Basic Vision plan and no dental
- Platinum+ medical benefits with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Platinum

SBC 470:
- Platinum medical benefits only
SBC 471:
- Platinum medical benefits with 24-month Basic Vision plan and no dental
- Platinum medical benefits with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Gold+

SBC 472:
- Gold+ medical benefits only
- Gold+ medical benefits with VSP vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 473:
- Gold+ medical benefits with 24-month Basic Vision plan and no dental
- Gold+ medical benefits with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Silver+

SBC 476:
- Silver+ medical benefits only
- Silver+ medical benefits with VSP vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 477:
- Silver+ medical benefits with 24-month Basic Vision plan and no dental
- Silver+ medical benefits with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Kaiser++

SBC 484:
- Kaiser++ HMO only
- Kaiser++ HMO with VSP vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 485:
- Kaiser++ HMO with 24-month Basic Vision plan and no dental
- Kaiser++ HMO with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Kaiser Signature & Select Low

SBC 488:
- Kaiser Signature or Select Low HMO only
- Kaiser Signature or Select Low HMO with VSP or Davis Vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 489:
- Kaiser Signature or Select Low HMO with 24-month Basic Vision plan and no dental
- Kaiser Signature or Select Low HMO with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Kaiser Select High

SBC 492:
- Kaiser Select High HMO only
- Kaiser Select High HMO with VSP or Davis Vision benefits and/or Delta Dental DPPO or DHMO dental benefits
SBC 493:
- Kaiser Select High HMO with 24-month Basic Vision plan and no dental
- Kaiser Select High HMO with 24-month Basic Vision plan and Delta Dental DPPO or DHMO dental benefits

Kaiser Colorado

Kaiser Georgia

Hospitality Plan

SPD

Evidence of coverage (EoC) files
Dental DHMO

Get your dental HMO EOC from Delta at deltadentalins.com/deltacare or by calling (800) 422-4234.
Please disregard the Eligibility and Termination sections in the EOC—the Fund determines who is eligible.

SBC: Gold+ - Silver+
SMMs