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Please choose your effective date to view benefits:
1/1/2010 thru 6/30/2010
7/1/2009 thru 12/31/2009
1/1/2009 thru 6/30/2009
7/1/2008 thru 12/31/2008
* Note: If you are unsure of your group effective date, please see your plan administrator.
Benefits Effective 1/1/2010 thru 6/30/2010
Medical
HMO: Cal
Choice
15, 25, 30, 40
PPO: Cal
Choice
750, 1000, 2400
Salud HMO y mas/Salud Mexico
Consumer's Choice
Active Choice 500
HSA 1500, 2400
Dental
FDH Access 100
Plan 3000
: Voluntary Dental
DHMO:
Plan 1000
and
Plan 3000
EPO:
Plan 3500
PPO:
Plan 4000, 5000
Vision
Hearing
Section 125
Life Insurance
Chiropractic/Acupuncture
Benefits Effective 7/1/2009 thru 12/31/2009
Medical
HMO: Cal
Choice
15, 25, 30, 40
PPO: Cal
Choice
750, 1000, 2400
Salud HMO y mas/Salud Mexico
Consumer's Choice
Active Choice 500
HSA 1500, 2400
Dental
FDH Access 100
Plan 3000
: Voluntary Dental
DHMO:
Plan 1000
and
Plan 3000
EPO:
Plan 3500
PPO:
Plan 4000, 5000
Vision
Hearing
Section 125
Life Insurance
Chiropractic/Acupuncture
Benefits Effective 1/1/2009 thru 6/30/2009
Medical
HMO: Cal
Choice
15, 25, 30, 40
PPO: Cal
Choice
750, 1000, 2400
Salud HMO y mas/Salud Mexico
Consumer's Choice
Active Choice 500
HSA 1500, 2400
Dental
FDH Access 100
Plan 3000
: Voluntary Dental
DHMO:
Plan 1000
and
Plan 3000
EPO:
Plan 3500
PPO:
Plan 4000, 5000
Vision
Hearing
Section 125
Life Insurance
Chiropractic/Acupuncture
Benefits Effective 7/1/2008 thru 12/31/2008
Medical
HMO: Cal
Choice
15, 25, 30, 40
PPO: Cal
Choice
750, 1000, 2400
Salud HMO y mas/Salud Mexico
Consumer's Choice
Active Choice 500
HSA 1500, 2400
Dental
FDH Access 100
Plan 3000
: Voluntary Dental
DHMO:
Plan 1000
and
Plan 3000
EPO:
Plan 3500
PPO:
Plan 4000, 5000
Vision
Hearing
Section 125
Life Insurance
Chiropractic/Acupuncture
Eligibility Requirements
Forms are created in PDF Format and you need Acrobat Reader, versions 4.0 and above to view them.
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Choice
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