Plan IV Summary of Benefits and Coverage

Indemnity Medical Plan (Anthem Blue Cross PPO): English (PDF)

Kaiser HMO Plan: English (PDF)

Anthem Blue Cross HMO Plan: English (PDF)

Your SBC is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in your Plan’s Summary Plan Description or by calling the TBT Plan Administration Office. Your Summary Plan Description includes the Guide to Your Benefits, Summary of Coverage, Comparison of Medical Benefits and Comparison of Dental Benefits.

Uniform Glossary

If you aren’t clear about the underlined terms used in the SBC, view or print the Uniform Glossary: English (PDF) | Español (PDF)