Plan Documents & Required Notices

Information about 2023 Benefit Summary Annual Reports
This message applies to you, if during 2023, you were a participant in, or beneficiary of one or more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2023 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I

401(k) Retirement Plan II

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

To view 2022 Plan documents, click here.

2023 Plan Documents & Required Notices

NWGA Local Plus Medical Neighborhood HSA Plan Summary Plan Description

Choice My Medical Neighborhood HSA Summary Plan Description

Choice Local Plus HSA Summary Plan Description

Choice OAP HSA Summary Plan Description

NWGA Local Plus Medical Neighborhood Copay Plan HSA Summary Plan Description

My Medical Neighborhood Copay Plan Summary Plan Description

Local Plus Copay Plan Summary Plan Description

OAP Copay Plan Summary Plan Description

MAC Standard Dental Plan

MAC Premium Dental Plan

Premium Access Plus Dental Plan

Out of Area Standard Plan Option

Out of Area Premium Plan Option

Vision Certificate of Insurance

Supplemental Life– Production Employees

Supplemental Life– Support Employees

Supplemental Life– Professional Employees

Supplemental Life– Sales Employees

Supplemental Life– Over the Road Truck Drivers

Summary of Benefits & Coverage (SBC's)

HSA Plans

NWGA Local Plus Medical Neighborhood Copay Plan HSA SBC

Choice My Medical Neighborhood HSA SBC

Choice Local Plus HSA SBC

Choice OAP HSA SBC

Copay Plans

NWGA Local Plus Medical Neighborhood Copay Plan HSA SBC

My Medical Neighborhood Copay Plan SBC

Local Plus Copay Plan SBC

OAP Copay Plan SBC

Other Plans

Employee Assistance

Other Notices

Important Notice Regarding Wellness Program

Women's Health and Cancer Rights Act Notice

Medicare Part D – Prescription Drug Coverage

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

2022 Summary Annual Reports (SARs)

Information about 2022 Benefit Summary Annual Reports
This message applies to you, if during 2022, you were a participant in, or beneficiary of one ore more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2022 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I

401(k) Retirement Plan II

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

To view 2021 Plan documents, click here.

2022 Plan Documents & Required Notices

NWGA Local Plus Medical Neighborhood HSA Plan Summary Plan Description

Choice My Medical Neighborhood HSA Summary Plan Description

Choice Local Plus HSA Summary Plan Description

Choice OAP HSA Summary Plan Description

NWGA Local Plus Medical Neighborhood Copay Plan HSA Summary Plan Description

My Medical Neighborhood Copay Plan Summary Plan Description

Local Plus Copay Plan Summary Plan Description

OAP Copay Plan Summary Plan Description

Summary of Material Modification-VIVIO Specialty Medications Program

MAC Standard Dental Plan

MAC Premium Dental Plan

Premium Access Plus Dental Plan

Vision Certificate of Insurance

Critical Illness Certificate (CIAA)

Critical Illness Policy (CIAA)

Grandfathered CI Certificate (CIIA)

Grandfathered CI Policy (CIIA)

401(k) Retirement Summary Plan Description

Amendment Six Plan 1 - Signed

Amendment Six Plan 2 - Signed

Summary of Benefits & Coverage (SBC's)

HSA Plans

NWGA Local Plus Medical Neighborhood HSA Plan
Choice My Medical Neighborhood HSA
Choice Local Plus HSA
Choice OAP HSA

Copay Plans

NWGA Local Plus Medical Neighborhood Copay Plan
My Medical Neighborhood Copay Plan
Local Plus Copay Plan
OAP Copay Plan

Other Plans

Employee Assistance

Other Notices

Important Notice Regarding Wellness Program

Women's Health and Cancer Rights Act Notice

Medicare Part D – Prescription Drug Coverage

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

2021 Summary Annual Reports (SARs)

Information about 2021 Benefit Summary Annual Reports
This message applies to you, if during 2021, you were a participant in, or beneficiary of one ore more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2021 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I (coming soon)

401(k) Retirement Plan II (coming soon)

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

To view 2021 Plan documents, click here.

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2021 Plan Documents & Required Notices

HSA Local Plus My Medical Neighborhood - Northwest Georgia

HSA My Medical Neighborhood with Cigna - Muskogee & Bennettsville

Open Access Plus H.S.A.

Local Plus H.S.A.

MAC Standard Dental Plan

MAC Premium Dental Plan

Premium Access Plus Dental Plan

Vision

Long Term Disability – Production Employees

Long Term Disability – Professional and Support Employees

Long Term Disability – Sales Employees

Long Term Disability – Over the Road Truck Drivers

Critical Illness Certificate

Accident Certificate

Supplemental Life– Production Employees

Supplemental Life– Support Employees

Supplemental Life– Professional Employees

Supplemental Life– Sales Employees

Supplemental Life– Over the Road Truck Drivers

Summaries of Benefits & Coverage (SBC)

HSA My Medical Neighborhood - Northwest Georgia - Summary of Benefits & Coverage (SBC)

HSA My Medical Neighborhood with Cigna - Summary of Benefits & Coverage (SBC)

Local Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Open Access Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Employee Assistance (Short Term Counseling)

Other Notices

Women's Health and Cancer Rights Act Notice

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

Medicare Part D – Prescription Drug Coverage

Looking for 2020 Plan year documents? Click here.

Summary Annual Reports (SARs)

Information about 2020 Benefit Summary Annual Reports
This message applies to you, if during 2020, you were a participant in, or beneficiary of one ore more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2020 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I

401(k) Retirement Plan II

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

Save

2020 Plan Documents & Required Notices

HSA Local Plus My Medical Neighborhood - Northwest Georgia

HSA My Medical Neighborhood with Cigna - Muskogee & Bennettsville

Local Plus H.S.A.

Open Access Plus H.S.A.

MAC Standard Dental Plan

MAC Premium Dental Plan

Premium Access Plus Dental Plan

Vision

Long Term Disability – Production Employees

Long Term Disability – Professional and Support Employees

Long Term Disability – Sales Employees

Long Term Disability – Over the Road Truck Drivers

Critical Illness Certificate

Accident Certificate

Supplemental Life– Production Employees

Supplemental Life– Support Employees

Supplemental Life– Professional Employees

Supplemental Life– Sales Employees

Supplemental Life– Over the Road Truck Drivers

Summaries of Benefits & Coverage (SBC)

HSA My Medical Neighborhood - Northwest Georgia - Summary of Benefits & Coverage (SBC)

HSA My Medical Neighborhood with Cigna - Summary of Benefits & Coverage (SBC)

Local Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Open Access Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Employee Assistance (Short Term Counseling)

Short-Term Disability Summary

Other Notices

Important Notice Regarding Wellness Program

Women's Health and Cancer Rights Act Notice

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

Health Care Plan Notice of Privacy Practices

Medicare Part D – Prescription Drug Coverage

Looking for 2019 Plan documents? Click here.

Summary Annual Reports (SARs)

Information about 2019 Benefit Summary Annual Reports
This message applies to you, if during 2019, you were a participant in, or beneficiary of one ore more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2019 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I

401(k) Retirement Plan II

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

2019 Plan Documents & Required Notices

HSA My Medical Neighborhood - Northwest Georgia

HSA My Medical Neighborhood with Cigna - Muskogee & Bennettsville

Local Plus H.S.A.

Open Access Plus H.S.A.

MAC Standard Dental Plan

MAC Premium Dental Plan

Premium Access Plus Dental Plan

Vision

Short-Term Disability Summary

Long Term Disability – Production Employees

Long Term Disability – Professional and Support Employees

Long Term Disability – Sales Employees

Long Term Disability – Over the Road Truck Drivers

401(k) Retirement

Critical Illness Certificate

Accident Certificate

Medical Summaries

H.S.A. My Medical Neighborhood - Northwest Georgia - Summary of Benefits & Coverage (SBC)

H.S.A. My Medical Neighborhood - Muskogee and Bennettsville - Summary of Benefits & Coverage (SBC)

Local Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Open Access Plus H.S.A. - Summary of Benefits & Coverage (SBC)

Other Notices

Important Notice Regarding Wellness Program

Health Care Plan Notice of Privacy Practices

Medicare Part D – Prescription Drug Coverage

Premium Assistance under Medicaid and the Children's Health Insurance Program Notice

Summary Annual Reports (SARs)

Information about 2018 Benefit Summary Annual Reports
This message applies to you, if during 2018, you were a participant in, or beneficiary of one ore more of the employee benefit plans listed below. To access a report, please click on a plan name below.

Why We Publish This Information
The Employee Retirement Income Security Act of 1974 (ERISA) requires that we share Summary Annual Reports (SARs) to all current and former employees who participated in any of the benefit plans for the 2018 plan year and to any beneficiaries who received or were entitled to receive benefits under a qualified retirement plan.

Health and Welfare Benefit Plans

401(k) Retirement Plan I

401(k) Retirement Plan II

If you would like to obtain a printed copy of any of the documents above, please call the Benefits Service Center at 1-866-481-4922.

2020 Benefits Guides Bttn Module Pink

This link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

Contact the BSC at 866-481-4922
Monday-Thursday 8:00-6:00 ET / Friday 8:00-5:00 ET

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