LUMD 403b Summary Plan Description

LUMD Retirement Plan Summary of Material Modifications Effective January 1, 2018

LUMD Health and Welfare Benefit Plan

LUMD Health & Welfare Benefit Plan Appendix

LUMD Health & Welfare Summary of Material Modifications Effective July 1, 2020

Summary of Benefits

This chart provides a summary of the benefits available under Loyola University Maryland Health & Welfare Benefit Plan. The benefit guides and insurance certificates listed below provide detailed information on the benefits available and are incorporated by reference into this Summary Plan Description. Please use the list below to identify the incorporated documents for the benefits in which you are enrolled. Please review this information carefully. If you have questions, need additional information, or wish to request a paper copy of the SPDs free of charge, please contact the Office of Benefits and Wellness at 410-617-1365.

Benefit	Insurer or Claims Administrator	Title of Benefit Booklet, Guide or Certificate
Medical OAP Plan OAP Certificate Rider - July 2022 OAP Certificate Rider MA - July 2022 OAP Compliance Rider - July 2022	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus Medical Benefits
Medical OAP-IN Plan OAP-IN Certificate Rider - July 1, 2022 OAP-IN Certificate Rider MA - July 1, 2022 OAP-IN Compliance Rider - July 1, 2022	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus In Network Medical Benefits
Medical OAP HDHP Plan OAP HDHP Certificate Rider - July 1, 2022 OAP HDHP Compliance Rider - July 1, 2022	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus Medical Benefits, Qualified High Deductive Health Plan
Dental PPO Dental Certificate Rider - LDA Dental Certificate Addendum Certificate Rider - Jan. 1, 2019 Certificate Rider - April 1, 2019 Certificate Rider - July 1, 2020	Metropolitan Life Insurance Company 200 Park Avenue New York, New York 10166	Your Employee Benefit Plan Dental Expense Benefits PPO Dental Plan
Dental Copay Plan Dental Certificate Rider - LDA Dental Certificate Addendum Certificate Rider - Jan. 1, 2019 Certificate Rider  - April 1, 2019 Certificate Rider - July 1, 2020 2020-2021 Dental Copay Rider - Copay Schedule	Metropolitan Life Insurance Company 200 Park Avenue New York, New York 10166	Your Benefit Plan Copay Dental Plan
Core Vision	Mid-Atlantic Vision Service Plan, Inc. 3333 Quality Drive Rancho Cordova, CA 95670	Group Vision Care Policy Certificate of Coverage
Vision Buy-up	Mid-Atlantic Vision Service Plan, Inc. 3333 Quality Drive Rancho Cordova, CA 95670	Group Vision Care Policy Certificate of Coverage
Basic Life/AD&D and Dependent Life Insurance	Principal Life Insurance Company Des Moines, IA 50392	Group Term Life, AD&D and Dependent Life Insurance Booklet
Supplemental Life Insurance	Principal Life Insurance Company Des Moines, IA 50392	Supplemental Life Insurance Booklet
Core LTD Insurance – Members with Pension Certificate Rider	Principal Life Insurance Company Des Moines, IA 50392	Core LTD  Insurance – Members with Pension Booklet
Core LTD Insurance – Members without Pension  Certificate Rider	Principal Life Insurance Company Des Moines, IA 50392	Core LTD  Insurance – Members without Pension Booklet
LTD Buy-Up – Members with Pension Certificate Rider	Principal Life Insurance Company Des Moines, IA 50392	LTD Buy-Up – Members with Pension Booklet
LTD Buy-Up – Members without Pension Certificate Rider	Principal Life Insurance Company Des Moines, IA 50392	LTD Buy-Up – Members without Pension Booklet
Employee Assistance Program	KEPRO 777 East Park Drive Harrisburg, PA 17111	Employee Assistance Program
Health Care Flexible Spending Accounts HFSA SMM Effective July 1, 2020	ConnectYourCare 307 International Circle, Suite 200 Hunt Valley, MD 21030	Flexible Benefits Plan Summary Plan Description

 

This website provides a summary of the benefits available. The University reserves the right to modify, amend, suspend or terminate any plan at any time, and for any reason without prior notification. You will be notified of any changes to these plans and how they affect your benefits, if at all. The plans described on this website are governed by insurance contracts and plan documents, which are available for examination. We have attempted to make explanations of the plans on this website as accurate as possible. However, should there be a discrepancy between this website and the provisions of the insurance contracts or plan documents, the provisions of the insurance contracts or plan documents will govern. In addition, you should not rely on any oral descriptions of these plans, since the written descriptions in the insurance contracts and plan documents will always govern.