Key: 

SAR = Summary Annual Reports
SBC = Summary of Benefits Coverage
SMM = Summary of Material Modifications
SPD = Summary Plan Description

Effective 1/1/21:

• 2021 SMM

Effective 1/1/20:

• HCA Mission Health System Health and Welfare Plan SPD
• First Amendment
• Second Amendment
• 2020 SMM

Effective 2020-2021:

• Fourth Amendment

Effective 2/1/19: HCA Mission Health System Health and Welfare Plan SPD

Effective 5/1/19: 

• Third Amendment

› This document bundles together all the different health and welfare benefits Mission Health offers. Check each plan’s SPD for specifics.

Notice of Non-Discrimination

Dental 

• SPD (effective Feb. 1, 2019)
• SPD (effective Jan. 1, 2019)

Disability

• 2019
  • LTD Certificate Class 1 / Executives
    • LTD Class 1 Amendment Eff. 2/1/2019
  • LTD Certificate Class 2 / Physicians
    • LTD Class 2 Amendment Eff. 2/1/2019
  • LTD Certificate Class 3 / All Other Employees
    • LTD Class 3 Amendment Eff. 2/1/2019
  • Short-Term Disability Certificate
    • STD Amendment Eff. 2/1/2019

Employee Assistance Program (EAP)

• SPD

Life and AD&D

• SPD 2019
• Life Insurance Plan Booklet and Certificate of Coverage (effective Jan 1-Jan 31, 2020)
• Life Insurance Plan Booklet and Certificate of Coverage (effective Feb 1, 2020)
• Guarantee Association Notice (effective Jan 1, 2020)

Retirement Plan

• 401(k) Plan SPD effective 2/1/19
• SMM #1 401(k)
• SMM #2 401(k)
• SMM #3 401(k)

• Children’s Health Insurance Program Notice (CHIPRA)
• COBRA Continuation Rights Under Federal Law
• 2021 Health Insurance Marketplace (New Coverage Options and Your Health Coverage)
• 2020 Medicare Part D (Prescription Drug Coverage and Medicare)
• 2021 Medicare Part D (Prescription Drug Coverage and Medicare)
• 2020 Medical Benefits Options Booklet (amended March 18, 2020)
• 2020 Medical Benefits Options Booklet (amended May 28, 2020)
• 2021 Medical Benefits Options Booklet
• Women’s Health and Cancer Rights Act (WHCRA)
• Special Enrollment Periods
• SBC MissionCare Plan (MCP) 2020
• SBC Health Savings Plan (HSP) 2020
• SBC MissionCare Plan (MCP) 2021
• SBC Health Savings Plan (HSP) 2021

Vision Plan

• SPD

Summary Annual Reports (SARs)

• SAR Feb 1-Dec 31, 2019: 401(k) Plan
• SAR Jan 1-Dec 31, 2020: MH Hospital Manager, LLC Employee Benefits Plan