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Summary of Benefits Coverage

The following plan documents are valid effective July 1, 2019 - June 30, 2020. 


Notices and Reports


Notice of Privacy Practices


Special Enrollment Rights

If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your plan dependents lose eligibility for that other coverage. However, you must request enrollment within 30 days after your or your dependents' other coverage ends.

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, or within 60 days after birth, adoption, or placement for adoption.

Finally, you and your dependents may have special enrollment rights if coverage is lost under Medicaid or a State health insurance ("SCHIP") program, or when you and/or your dependents gain eligibility for state premium assistance. You have 60 days from the occurrence of one of these events to notify us and enroll in the plan.

To request special enrollment or obtain more information, contact Human Resources at 667.4700.

Women's Health and Cancer Rights Act

The Premera and Group Health Alliant Plus plans, as required by the Women's Health and Cancer Rights Act of 1998, provide benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between the breasts, prostheses and treatment of complications resulting from a mastectomy (including lymphedema). These reconstructive benefits may be subject to calendar year deductibles and coinsurance provisions like other medical and surgical benefits covered under the plan.

Newborn and Mother's Health Protection Act

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a Cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Notice of Plan Termination

SCCA's Retiree Health Plan is terminated, effective July 1, 2016.