Welcome to the Document Library. Here you’ll find forms, notices and up-to-date documents regarding your benefits.
Plan Booklets and Summaries
- SoundPlus ACO Summary of Benefits and Coverage
- Sound Plan PPO Summary Plan Description 4-2017
- SoundPlus Plan PPO Summary Plan Description 4-2017
- Sound Plan Benefit Eligibility Timeline
- Dependent Definition Change April 2011
- SoundPlus PPO, Kaiser and ACO Medical Benefits Comparison
- Sound Plan Under 36 Months – Medical Comparison
- Sound Plan Over 36 Months – Medical Comparison
- Sound Plan Under 36 Months Out of Area – Medical Comparison
- SoundPlus Plan – Medical Comparison
- Sound Plan – Dental Comparison
- SoundPlus Plan – Dental Comparison
- Sound Summary of Benefits and Coverage
- SoundPlus Summary of Benefits and Coverage
COVID-19 Related Benefit Plan Change Notices
- SoundPlus Plan PPO Summary of Material Modifications – COVID-19 Changes Dated December 2020
- Sound Plan PPO Summary of Material Modifications – COVID-19 Changes Dated December 2020
- SMM Extension of Waivers & Neurodevelopmental Benefit Change-October 2020
- Sound Plan PPO Summary of Material Modifications – COVID-19 Changes Dated July 2020
- SoundPlus Plan PPO Summary of Material Modifications – COVID-19 Changes Dated July 2020
- SoundPlus Plan PPO Summary of Material Modifications Dated May 2020
- Sound Plan PPO Summary of Material Modifications Dated May 2020
- SoundPlus Plan PPO Summary of Material Modifications – COVID-19 Changes Dated April 2020
- Sound Plan PPO Summary of Material Modifications – COVID-19 Changes Dated April 2020
Benefit Plan Change Notices
- SMM Extension of Waivers & Neurodevelopmental Benefit Change-October 2020
- SoundPlus Plan PPO Summary of Material Modifications Dated May 2020
- Sound Plan PPO Summary of Material Modifications Dated May 2020
- SoundPlus Plan PPO Summary of Material Modifications Dated 4-1-2020
- Sound Plan PPO Summary of Material Modifications Dated 4-1-2020
- SoundPlus PPO Plan Summary of Material Modifications Dated 5-15-2018
- Sound PPO Plan Summary of Material Modifications Dated 5-15-2018
Doctor On Demand
HRA Health Related Actions Forms
Forms
Pharmacy Information
Policies
- Weight Loss Surgery Policy – Spanish
- Weight Loss Surgery Policy – English
- Applied Behavior Health Analysis (ABA) Coverage Policy
- Hepatitis C Pharmaceutical Coverage Policy
- Gender Dysphoria Policy effective 06 01 2015
- Prophylactic Mastectomy and BRCA Testing Policy
- Procedures for Filing Claims and Appeals
Other Plan Documents
- 2022 Sound Plan Dental Fee Schedule
- 2022 SoundPlus Plan Dental Fee Schedule
- Name Change Form
- Notice Regarding Wellness Program – Sound Health & Wellness Trust
- SHWT Beneficiary Change Form
- General COBRA Notice
- Notice of Privacy Practices Revised September 23, 2013
- Summary Annual Report – Sound Health & Wellness Trust
- Glossary of Health Coverage and Medical Terms