Documents & Forms

Plan Documents

Summary Plan Description (SPD) and Summary of Benefits and Coverage (SBC) documents provide detailed information about the plans provided under the Employment Retirement Income Security Act of 1974. They contain the plan administrator’s identity, requirements for eligibility and participation in the plan, circumstances that may result in disqualification or denial of benefits, and the identity of insurers.

Medical

Summary Plan Description (SPD)

(Non-Represented Employees) Johns Hopkins EPO Plan + Short-term Disability SPD

(Represented Employees) Johns Hopkins EPO Plan + Short-term Disability SPD

(Non-Represented Employees) Johns Hopkins PPO Plan + Short-term Disability SPD

(Represented Employees) Johns Hopkins PPO Plan + Short-term Disability SPD

Summary of Benefits and Coverage (SBC)

Johns Hopkins EPO Plan SBC

Johns Hopkins PPO Plan SBCs:

• Low Tier (up to $50k salary)
• Mid Tier ($50k–$120k salary)
• High Tier ($120k+ salary)

Johns Hopkins DPC Plan SBCs: 

• Low Tier (up to $50k salary)
• Mid Tier ($50k–$120k salary)
• High Tier ($120k+ salary)

Summary Plan Descriptions

Summary Plan Descriptions (SPDs) provide detailed information about the plans provided under the Employment Retirement Income Security Act of 1974. They contain the plan administrator’s identity, requirements for eligibility and participation in the plan, circumstances that may result in disqualification or denial of benefits, and the identity of insurers.

Medical, dental and vision

UNION: For Represented Employees

EHP EPO  (includes Short-term disability)

EHP PPO   (includes Short-term disability)

For Non-Represented Employees

EHP EPO  (includes Short-term disability)

EHP PPO  (includes Short-term disability)

Disability

Disability Income Insurance (full-time Union employees)

Disability Income Insurance (includes certain other groups)