Forms & Plan Documents

Type

- Any -FormsNewslettersOther DocumentsPlan DocumentsRequired NoticesSummary of Annual Reports (SAR)Summary of Benefits and Coverage (SBC)Summary of Material Modification (SMM)Summary Plan Description (SPD)

Plan

- Any -DentalDisabilityFlexible Spending AccountsLife InsuranceMedicalOther Plans and ProgramsVision

Provider

- Any -AetnaAlightCignaCVS CaremarkHMO Blue—MassachusettsKaiser—CaliforniaMatrixMinnesota Life Insurance CompanyOptumOtherUnitedHealthcareVSPZurich

Forms

• Adoption Assistance Reimbursement Form
• Affidavit of Domestic Partnership
• Business Travel Accident Claim Form (Zurich)
• Business Travel Dismemberment Claim Form (Zurich)
• Dependent Care Flexible Spending Account (FSA) Claim Form
• Evidence of Insurability Form
• Flu Shot Consent Form
• Health Care Flexible Spending Account (FSA) Claim Form
• Intuit Domestic Partner Benefit Program Certification of Legal Tax Dependents Affidavit
• Option to Port Term Life Insurance Coverage
• Securian Life Conversion Information
• Surrogacy Assistance Program Reimbursement Request Form

Newsletters

• April Newsletter
• August Newsletter
• March Newsletter
• May Newsletter

Other Documents

• Benefits at a Glance
• Best Doctors FAQs
• Business Travelers Accident (BTA) Customer Agreement ID Theft
• Business Travelers Accident (BTA) Insurance Identity Theft Brochure
• Business Travelers Accident Secure Travel Wallet Card
• Cigna Choice Fund HSA Creditable Coverage MA Rider
• Cigna Envoy Registration Guide
• COVID-19 Educational Resources
• COVID-19 Mindfulness Support
• COVID-19 Stress Management
• Dependent Verification Required Documents
• ESPP Enrollment Guide for E*Trade
• FY 2022 Plan Snapshot
• Health Care Reform Eligibility
• HealthEquity Customer Identification Process
• How to Liquidate Investments
• HSA: Customer Identification Process (CIP) Overview
• Medicare Coordination of Benefits
• Optum EAP and WorkLife Services Benefit
• Optum Remote Well-Being Toolkit Issue 1
• Optum Remote Well-Being Toolkit Issue 2
• Optum Remote Well-Being Toolkit Issue 4
• Redpoint Travel Assistance FAQ
• Rethink 10 Tips for Supporting Your Kids Right Now
• SDI/VDI Comparison Chart 2021

Plan Documents

• Aetna DMO Summary of Benefits
• Aetna DPO Summary of Benefits
• Cigna International Certificate of Insurance
• Cigna Transition of Care
• ESPP Prospectus
• Intuit Inc. Consolidated Welfare Plan
• Intuit Inc. Consolidated Welfare Plan Amendment
• Intuit Inc. Flexible Benefit Plan
• Intuit Inc. Flexible Benefit Plan Amendment
• Kaiser Permanente: Get the Right Care for You
• Kaiser Transgender Benefits
• UHC Transition of Care
• VSP Vision Benefits Summary

Required Notices

• Cal-COBRA Notice
• CHIP Notice 2020
• Genetic Information Nondiscrimination Act Notice
• Health Insurance Marketplace Notice
• HIPAA Amendment to Consolidated Welfare Benefit Plan
• HIPAA Privacy Notice
• Newborns' and Mothers' Health Protection Act Notice
• Notice of Special Enrollment Periods
• Women’s Health and Cancer Rights Act Required Annual Notice

Summary Plan Description (SPD)

• 401(k) Summary Plan Description
• Summary of Material Modifications (SMM) for the Intuit Consolidated Welfare Plan–FY 2021

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