Click on the links below to view Plan IV materials in PDF format. See the Plan Updates page for Plan notices mailed after these materials were printed.
Your Summary Plan Description
Together, the materials posted below provide all the information you need to use your TBT Plan. Printed versions of these documents are provided to covered participants in a green folder called Your Benefits Package, technically known as a Summary Plan Description. If for some reason the online materials are incomplete or inconsistent with the printed Summary Plan Description materials, the printed versions will be controlling.
Guide to Your Benefits (PDF coming soon) – This Guide explains how you become eligible for coverage, how to make or appeal a benefit claim and your rights under federal benefits and privacy laws. A printed copy is available through the TBT Plan Administration Office.
Plan IV Summary of Coverage (PDF) – This Summary explains the specific benefits, provisions and limitations that apply to your TBT Plan.
Plan IV Comparison of Medical Benefits (PDF) – This Comparison helps you compare your Plan’s choice of medical options (including the TBT Indemnity Medical option and HMOs available at your location).
Plan IV Comparison of Dental Benefits (PDF) – This Comparison helps you compare your Plan’s choice of dental options (including the TBT Indemnity Dental option and prepaid dental options available at your location).
Your Summary of Benefits and Coverage (SBC)
Under health care reform laws, group health plans like TBT must provide active participants with a Summary of Benefits and Coverage (SBC) for the medical plan options they choose.