COBRA/ Early Retirees/ Retirees

Medicare Part D Notice

• Dental and Vision COBRA Contribution Chart
• Delta Care HMO Plan Documents
• Delta Dental Plan A (SMUHSDTA) Plan Document
• Delta Dental Plan D (All Others) Plan Document
• VSP Plan Document
• Kaiser HMO EOB     
• Kaiser HMO ACN (Chiro/Acupuncture)              
• Kaiser HDHP EOB
• Kaiser HDHP ACN (Chiro/Acupuncture)
• Sutter Health HMO EOB
• Sutter Health ACN (Chiro/Acupuncture)
• Sutter Health HDHP EOB

• Dental and Vision COBRA Contribution Chart
• Delta Care HMO Plan Documents
• Delta Dental Plan A (SMUHSDTA) Plan Document
• Delta Dental Plan D (All Others) Plan Document
• VSP Plan Document
• Kaiser HMO EOB     
• Kaiser HMO ACN (Chiro/Acupuncture)              
• Kaiser HDHP EOB
• Kaiser HDHP ACN (Chiro/Acupuncture)
• Sutter Health HMO EOB
• Sutter Health ACN (Chiro/Acupuncture)
• Sutter Health HDHP EOB

• Delta Dental AB528 (Certificated ONLY)
• Kaiser KPSA $10 Plan Summary
• Kaiser KPSA $20 Plan Summary