Important Schedules of Benefits and Plan Descriptions
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AMRI Rennselaer, Inc.
- no new docs provided -
Aristech
- no new docs provided -
Best Buds
Summary Plan Description (English)
Summary Plan Description (Spanish)
Schedule of Benefits (English) Eff. April 1, 2020
Schedule of Benefits (Spanish) Eff. 1 Abril de 2020
Summary of Benefits and Coverages
Summary of Material Modifications - New Benefit Plan (Eff. June 1, 2026)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Ef. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Cantu Services Inc.
- no new docs provided -
Catalyst 316 Florence
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Summary of Material Modifications - Discount Coupon CoPay
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Bellflower and Bellflower Distro
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages - PPO Buy-Up Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Belmont Shores
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Cherry
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Hemet
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Downtown Long Beach
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst EEL El Monte
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst EEL Pomona, LLC
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2026)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Palm Desert
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Figueroa
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Mid City
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Normadie
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026)
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Pacific Roots Marina
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Catalyst RD Stanton
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst RDx Baldwin Park
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst RDx Costa Mesa
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst RDx MoVal, LLC
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst RDx San Bernardino
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Santa Ana
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Catalyst Silver Lake - Puradora, LLC
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan
Summary of Benefits and Coverages – High Ded Plan (Eff. August 1, 2025)
Dental Plan Summary (if elected)
Catalyst South Cord Holdings
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits (English) Eff. June 1, 2026
Schedule of Benefits (Spanish) Efectivo el 1 de junio de 2026
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
Constellation Brands U.S. Operations, Inc. - Mission Bell Winery
CSL Behring EPO Plan
Schedule of Benefits (Eff. March 1, 2022)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
CSL Behring PPO Plan
Schedule of Benefits (Eff. January 1, 2021)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Curia New York, Inc
Schedule of Benefits (PPO Plan) Eff. March 1, 2020
Schedule of Benefits (HDHP Plan) Eff. March 1, 2020
Summary of Benefits and Coverages (PPO)
Summary of Benefits and Coverages (HDHP)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Delano Growers Grape Product
Diageo Select Plan
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Summary of Material Modifications - Discount Coupon CoPay
Diageo Standard Plan
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Discovery Behavioral Healthcare
Schedule of Benefits (Eff. April 1, 2020)
Summary of Benefits and Coverages
Summary of Material Modifications - New Benefit Plan (Eff. June 1, 2026)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
DW Richards & Sons, Inc.
The Wine Group – Franzia (Ripon)
Summary Plan Description (English)
Summary Plan Description (Spanish)
Schedule of Benefits (English) Eff. August 1, 2019
Schedule of Benefits (Spanish) Efectivo el 1 de agosto de 2019
Summary of Benefits and Coverages
Dental Benefit Summary (English)
Dental Benefit Summary (Spanish)
Vision Benefit Summary (English)
Vision Benefit Summary (Spanish)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Summary of Material Modifications - Life Insurance Benefits (Eff. April 1, 2008)
Fresh Delaware, LLC
Schedule of Benefits (Eff. April 1, 2020)
Summary of Benefits and Coverages
Summary of Material Modifications - New Plan Benefits (Eff. June 1, 2026)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Gallo Wine Sales of NJ
Schedule of Benefits (Eff. February 1, 2023)
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice (Eff. February 1, 2023)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Summary of Material Modifications - Applied Behavioral Analysis (Eff. May 1, 2018)
Gary & Leo's Fresh Foods of Harvre
Summary of Benefits and Coverages
GAC PPO Plan
Schedule of Benefits (Eff. September 1, 2022)
Summary of Benefits and Coverages
Summary of Material Modifications- Terminations of Dental Benefits (Eff. June 1, 2026)
GAC HDHP Plan
Schedule of Benefits (Eff. September 1, 2022)
Summary of Benefits and Coverages
Summary of Material Modifications- Termination of Dental Benefits (Eff. June 1, 2026)
Gleason - Buy Up PPO
Schedule of Benefits (Eff. November 1, 2025)
Summary of Benefits and Coverages
Gleason B-60 - Plan Basic PPO
Schedule of Benefits (Eff. June 1, 2025)
Summary of Benefits and Coverages
Glendive BN Federal Credit Union
Schedule of Benefits (Eff. July 1, 2025)
Golden State Vintners, Inc
Healthcare Service Group, Inc
Summary Plan Description Amendment
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Jim Beam Brands Co. Local 111-D
Schedule of Benefits (Eff. September 1, 2025)
Summary of Benefits and Coverages
Jim Beam Brands Co. Local 227
Schedule of Benefits (Eff. September 1, 2025)
Summary of Benefits and Coverages
JLL EPO Plan
Schedule of Benefits (Eff. January 1, 2022)
Summary of Benefits and Coverages
Summary of Material Modifications - Increase Life Insurance Benefits (Eff. November 1, 2022)
JLL PPO Plan
Schedule of Benefits (Eff. January 1, 2022)
Summary of Benefits and Coverages
Summary of Material Modifications - Increase Life Insurance Benefits (Eff. November 1, 2022)
Local 2D
Schedule of Benefits (Eff. February 1, 2023)
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice (Eff. February 1, 2023)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Local 18
Schedule of Benefits (Eff. February 1, 2023)
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice (Eff. February 1, 2023)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Metropolitan Baltimore Council AFL-CIO
Schedule of Benefits (Eff. October 1, 2020)
Summary of Benefits and Coverages
Summary of Material Modifications - Participating Provider Network Changes (Eff. January 1, 2024)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Minnesota Freezer Warehouse Company
Mountaineer Park, Inc. - Buy Up Plan
Schedule of Benefits (Eff. October 1, 2025)
Summary of Benefits and Coverages
Mountaineer Park, Inc. - Core Plan
Mr. Nice Guy
Summary Plan Description (English)
Summary Plan Description (Spanish)
Schedule of Benefits (English)
Schedule of Benefits (Spanish)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Nouryon Surface Chemistry, LLC
Schedule of Benefits (Eff. January 1, 2021)
Summary of Benefits and Coverages (100/50 Elite Plan)
Summary of Benefits and Coverages (90/70 PPO Plan)
Summary of Benefits and Coverages (HMO Plan)
Summary of Material Modifications - Dental Plan Benefit Change (Eff. January 1, 2023)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Rogers Corporation Delaware
High Option HSA Plan
Schedule of Benefits (Eff. January 1, 2019)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Low Option HSA Plan
Schedule of Benefits (Eff. January 1, 2019)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
PPO Plan
Schedule of Benefits (Eff. January 1, 2019)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Service Linen Supply
International Union of Operating Engineers Local 302
Summary Plan Description – Plan A
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
Service Linen Supply Management Staff
Summary Plan Description – Plan A
Summary Plan Description – Plan B
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Schedule of Benefits – Plan B (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
Summary of Benefit Coverages – Plan B
Teamsters Local 117
Summary Plan Description – Plan A
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
UFCW Local 3000
Summary Plan Description – Plan A
Summary Plan Description – Plan B
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Schedule of Benefits – Plan B (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
Shaw's Supermarkets, Inc. - Methuen Distribution Center
Schedule of Benefits (Eff. March 1, 2020)
Summary of Benefits and Coverages
Summary of Material Modifications - Out-of-Pocket Maximum Increase (Eff. March 1, 2026)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Shaw's Supermarkets, Inc. - Southern Region Stores and Wells Distribution Center
Summary Plan Description (English)
Summary Plan Description (Spanish)
Schedule of Benefits (Eff. January 1, 2020)
Summary of Benefits and Coverages
Summary of Benefits and Coverages - Southern Region Stores Plan B
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Silgan Containers Manufacturing Corporation
Schedule of Benefits (Eff. January 1, 2025)
South Coast Safe Access
Southern Glazer's Wine and Spirits of New York, Inc
Schedule of Benefits (Eff. January 1, 2021)
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice (Eff. February 1, 2023)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Starfire Lighting, Inc
Sterling Care Frostburg Village
Summary Plan Description Amendment
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Sterling Care Frostburg Village Assisted Living
Summary Plan Description Amendment
Summary of Benefits and Coverages
Summary of Material Modifications - Provider Network Transition Notice
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
Sun Chemical Corporation
Sun-Maid Growers of California
Superior Linen Service, Inc. Management Staff
Summary Plan Description – Plan A
Summary Plan Description – Plan B
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Schedule of Benefits – Plan B (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
Summary of Benefit Coverages – Plan B
Teamsters 117
Summary Plan Description – Plan A
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
UFCW Local 3000
Summary Plan Description – Plan A
Summary Plan Description – Plan B
Schedule of Benefits – Plan A (Eff. December 1, 2023)
Schedule of Benefits – Plan B (Eff. December 1, 2023)
Summary of Benefit Coverages – Plan A
Summary of Benefit Coverages – Plan B
The Station
Summary Plan Description (English)
Summary Plan Description (Spanish)
Schedule of Benefits (English)
Schedule of Benefits (Spanish)
Summary of Benefits and Coverages
Summary of Material Modifications - Specialty Drug Cost Avoidance Program
TWG Almaden Madera Winery
UFCW Local 324
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Schedule of Benefits- English (Eff. June 1, 2026)
Schedule of Benefits- Spanish (Efectivo el 1 de junio de 2026)
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
UFCW Local 1428
Unicann Plan
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish)- UNICANN Basic Plan
Schedule of Benefits- English (Eff. June 1, 2026)
Schedule of Benefits- Spanish (Efectivo el 1 de junio de 2026)
Summary of Benefits and Coverages - UNICANN Basic Plan
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
The 420 Plan
Schedule of Benefits – PPO Buy-Up Plan (Eff. April 1, 2026)
Summary of Benefits and Coverages
Dental Plan Summary (if elected)
Vision Plan Summary (if elected)
Cannabis High Deductible Plan
Summary Plan Description - High Ded Plan
Schedule of Benefits – High Ded Plan (Eff. August 1, 2025)
Summary of Benefits and Coverages – High Ded Plan
Dental Plan Summary (if elected)
UFCW National Fund Medigap Plans
Summary Plan Description (Medigap Plan) Eff. May 1, 2025
Summary Plan Description (Supplemental Medigap Plan) Eff. May 1, 2025
UFCW National Health & Welfare Fund Staff Plan
Schedule of Benefits (Eff. August 1, 2024)
Summary of Benefits and Coverages
Summary of Material Modifications - Changes in Benefits (Eff. May 1, 2025)
Union Club Bar & Grill
Ventura Foods, LLC
Schedule of Benefits (Eff. January 1, 2021)
Summary of Benefits and Coverages
Dental Benefit Summary - Basic
Dental Benefit Summary - Buy-UP
Vision Benefit Summary - Basic
Vision Benefit Summary - Buy-UP
Summary of Material Modifications - Participating Provider Network Changes (Eff. October 1, 2022)
Summary of Material Modifications - Specialty Drug Cost Avoidance Program (Eff. July 1, 2021)
Summary of Material Modifications - Discount Coupon CoPay (Eff. July 1, 2019)
Vie-Del Company, Plants I & II
WEPCO Federal Credit Union
Summary Plan Description (English) - UNICANN Basic Plan
Summary Plan Description (Spanish) - UNICANN Basic Plan
Summary Plan Description Amendment (Eff. January 1, 2021)
Schedule of Benefits- English (Eff. June 1, 2026)
Schedule of Benefits- Spanish (Efectivo el 1 de junio de 2026)
Summary of Benefits and Coverages
Summary of Material Modifications - Participating Provider Network Changes (Eff. October 1, 2023)
The Plan may be amended by the Trustees in the manner provided in the Trust Agreement. Amendments may apply to all groups covered or to certain groups only. Amendments may be made retroactively only to the extent permissible under ERISA, the Internal Revenue Service and other applicable laws.
The following information is current as of the date indicated. The Plan is modified by the Board of Trustees from time to time. Please check with the Fund Office for very recent changes before making decisions that may impact your benefits. Only the Board of Trustees has the power to construe the Plan and its terms.
For more information please email UFCW Member Support at [email protected]