Plan Documents: Generic

Plan Documents: Generic

(Must have Acrobat Reader to view PDF documents, download is free)

If your plan is a grandfathered small employer plan (50 or fewer employees):

300 80/60 plan w/out mental illness coverage (PDF)
300 80/60 plan w/mental illness coverage (PDF)
500 80/60 plan (PDF)
300 90/80 plan (PDF)
500 90/80 plan (PDF)
1000 90/80 plan (PDF)

If your plan is a grandfathered large employer plan (51 or more employees):

150 80/60 plan (PDF)
500 80/60 plan (PDF)
1000 90/80 plan (PDF)

If your plan is a non-grandfathered transitional small employer plan (50 or fewer employees):

150 90/80 plan (PDF)
1000 80/60 plan (PDF)