Find your plan documents and notices here
See below for a list of important documents and notices for our various benefits and programs. Not seeing what you’re looking for? Check the full library search feature at the bottom of this page.
Benefits Guides
*linked documents are for internal use only
Cigna
2024 Cigna OAPIN Summary of Benefits and Coverage
2024 Cigna OAP Summary of Benefits and Coverage
Personal Champion – Gender Affirmation
Coaching and Support for Autism
Dental
2024 Delta Dental Plan Summary
Compliance
2024 Marketplace Coverage Notice
Affirm 2021 Summary Annual Report (SAR)
Changes to CA State Disability Insurance (SDI) RateÂ
Additional Resources
Health Plan Notices
These notices must be provided to plan participants on an annual basis and are available in the Annual Notices document.
- Medicare Part D Notice: Describes options to access prescription drug coverage for Medicare-eligible individuals
- Women’s Health and Cancer Rights Act: Describes benefits available to those that will or have undergone a mastectomy
- Newborns’ and Mothers’ Health Protection Act: Describes the rights of the mother and newborn to stay in the hospital 48-96 hours after delivery
- HIPAA Notice of Special Enrollment Rights: Describes when you can enroll yourself and/or dependents in health coverage outside of open enrollment
- HIPAA Notice of Privacy Practices: Describes how health information about you may be used and disclosed
- Notice of Choice of Providers: Notifies you that your plan requires you to name a Primary Care Physician (PCP) or provides for you to select one
- Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP): Describes the availability of premium assistance for Medicaid eligible dependents.
Your Document & Flyer Library
Don’t see what you’re looking for above? Feel free to browse the Affirm Benefits Document Library below. You can sort by topic and document type to find what you’re looking for.
- Fertility & Family Building
- Caregiver Support
- Prudential
- Notices
- Compliance
- Forma Wallets
- Medical (HMSA)
- HMSA
- Beneficiary Services
- Identity Protection
- Mental Health
- Dental
- Autism Support
- Hearing
- Transgender Support
- Medical (Cigna)
- Medical (Kaiser)
- Program Wide
- Legal
- Financial
- Welfare
- Vision
- Plan Documents
- Links
- Flyers
- Documents
AFRM 2022-23 HMSA PPO SGP 30K SBC
