2023 Plan and Legal Documents
Benefits Dept. Guides
Aflac
Accident
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Aflac Accident High Plan Dependent Rider
HISD_2019_AFLAC_Accident_High_Plan_Dependent_Rider.pdf 138.15 KB (Last Modified on November 4, 2020)
Critical Illness
Cancer & Specified Diseases
Life Insurance
Policy Plan Documents
Legal Documents
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HISD 2022 Legal Notices Disclosures
HISD 2022 Legal Notices Disclosure - w Non Creditable Coverage Lang.pdf 757.9 KB (Last Modified on November 11, 2021)
Medical Plans
Medical Plan Summaries
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2023 Kelsey Seybold ACO Summary Benefits and Coverage
2023KelseyBasicACOSummaryBenefits-Coverage_SBC_091823.pdf 867.6 KB (Last Modified on September 18, 2023) -
2023 Kelsey Seybold Plus ACO Summary Benefits and Coverage
2023KelseyPlusACOSummaryBenefits-Coverage_SBC_091823.pdf 867.69 KB (Last Modified on September 18, 2023) -
2023 Kelsey Select ACO Summary of Benefits and Coverage
2023KelseySelectACOSummaryBenefits-Coverage_SBC_091823.pdf 847.75 KB (Last Modified on September 18, 2023) -
2023 Memorial Hermann Basic ACO Summary and Benefits
2023MemorialHermannBasicACOSummary-Benefits-Coverage_SBC_091823.pdf 845.2 KB (Last Modified on September 18, 2023) -
2023 Memorial Hermann Plus Summary and Benefits
2023Memorial-Hermann-PlusACOSummary-Benefits-Coverage_SBC_091823.pdf 846.52 KB (Last Modified on September 18, 2023) -
2023 TX Medical Neighborhood Basic Summary Benefits and Coverage
2023TXMedicalNeighborhood-BasicSummary-Benefits-Coverage_SBC_091823.pdf 848.29 KB (Last Modified on September 18, 2023) -
2023 TX Medical Neighborhood Plus Summary Benefits and Coverage
2023TXMedicalNeighborhoodPlus-Summary-Benefits-Coverage_SBC_091823.pdf 847.93 KB (Last Modified on September 18, 2023)
Prescription Drugs
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2023 Express Scripts National Preferred Formulary with Exclusion List
2023 National Preferred Formulary Alpha with Exclusion List.220902.pdf 222.67 KB (Last Modified on July 26, 2023) -
2023 Express Scripts High Performance Formulary Alpha
2023 High Performance Formulary Alpha PRMT1703A-23.CRP2205_0016034.1.220902.pdf 83.64 KB (Last Modified on July 26, 2023)
Dental
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Cigna Dental DHMO or DPPO
Take this quiz to find the right dental plan.
DHMO DPPO Dual Option Decision Guide Access Plus Network.pdf 192.02 KB (Last Modified on September 4, 2020) -
Cigna Dental DHMO plan
View this flyer for savings and coverage.
DHMO Product Customer Brochure - Access Plus Network.pdf 545.15 KB (Last Modified on September 4, 2020) -
Cigna Dental DHMO Access Plus Network
How to find a dentist
DHMO Access Plus Network Dentist How to Find a Dentist Customer Flyer.pdf 47.56 KB (Last Modified on September 4, 2020) -
Cigna Dental DHMO Access Plus Network Español
DHMO Product Customer Brochure - Access Plus Network - Spanish.pdf 383.58 KB (Last Modified on October 23, 2020)