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DISCLAIMER:
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the
official plan documents. In case of any discrepancies, the official plan documents will govern.
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Table of Contents
Benefits That Fit ........................................................................................................................................... 4 Eligibility & Enrollment................................................................................................................................ 5 Making the Most of Your Benefits Program ................................................................................................ 6 Medical ....................................................................................................................................................... 7 Sharp Tools & Resources .............................................................................................................................. 8 Kaiser Tools & Resources ............................................................................................................................. 9 Kaiser Permanente & Sharp HMO Child Dental Plans (Children Only) ................................................... 10 Dental........................................................................................................................................................ 11 Vision......................................................................................................................................................... 12 Life and AD&D Insurance ......................................................................................................................... 13 Disability Insurance .................................................................................................................................. 13 Cigna Value Added Benefits .................................................................................................................... 14 Important Plan Notices and Documents................................................................................................... 15 COBRA Initial (General) Notice ................................................................................................................. 15 Women’s Health and Cancer Rights Annual Notice ................................................................................ 16 Newborns’ and Mothers’ Health Protection Act Notice ............................................................................ 17 HIPAA Notice of Special Enrollment Rights .............................................................................................. 17 Notice of Choice of Providers .................................................................................................................... 17 Michelle’s Law Notice ............................................................................................................................... 17 Medicare Part D Notice ............................................................................................................................. 18 Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) ................. 20 For Assistance ........................................................................................................................................... 23Medicare Part D Notice: If you (and/or your dependents) have Medicare or
will become eligible for Medicare in the next 12 months, a federal law gives
you more choices about your prescription drug coverage. Please see the
Annual Notices on pages 15 - 16 for more details.
Statement of Material Modifications
This benefit guide constitutes a Summary of Material Modifications (SMM) to the Pro Specialties Group, Inc.
Health Plan. It is meant to supplement and/or replace certain information in the SPD, so retain it for future
reference along with your SPD. Please share these materials with your covered family members.