Other Forms

2009 ProtectPlus EZ Guide Brochure
2009 EZ Guide

Summary Plan Descriptions (SPD's)
2008 Protect 10 SPD
2008 Protect 15 SPD
2008 Protect 25 SPD
2008 Protect 25 Enhanced SPD
2008 Protect 35 SPD
2008 Protect 45 SPD
2008 Protect HSA 1500 SPD
2008 Protect HSA 2850 SPD

Please Note: The Summary Plan Description for each benefit design and the related rate filings filed with the California Department of Insurance for each design constitute the Group Insurance Trust Rating Manual.  The Rating Manual contains information sufficient to verify that ProtectPlus and related dental and vision plans satisfy the requirements of Section 419A(f)(6).  The trustees are required to maintain a record of the Rating Manual for all years of operations.  Upon written request addressed to the Trustees of the Group Insurance Trust, a participating employer, the representative of a participating employer, or the Commissioner of Internal Revenue may obtain access to view and copy any such records.

HSA Forms and Information
2009 Alliant Credit Union, Bank of New York Mellon and US Bank Fee Comparison
HSA Q&A
Alliant Credit Union - Credit Union Fees
Mellon - US Bank Investment Options Comparison
Mellon/US Bank Employer Set Up Form
US Bank Product Guide

Miscellaneous Forms and Information
Change Form
Disabled Dependent Certification Form
COBRA Notification Form For Employees
CALCOBRA Information
Domestic Partner Information & Affidavit
Automatic Payment Authorization
Anthem Blue Cross Healthy Extensions Brochure

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