Plan Documents and Forms
2023–2024 Benefit Year Documents
2024 FSA Summary Plan Description
2023 Anthem HMO Medical Plan Benefits Summary [PDF]
2023 Anthem PPO Medical Plan Benefits Summary [PDF]
2023 FSA Summary Plan Description [PDF]
2023 New York Life AD&D (Non-U.S. Citizen) Benefit Summary [PDF]
2023 New York Life AD&D (U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Life Insurance (Non-U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Life Insurance (U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Long-Term Disability (Non-U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Long-Term Disability (U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Short-Term Disability (Non-U.S. Citizen) Benefit Summary [PDF]
2023 New York Life Short-Term Disability (U.S. Citizen) Benefit Summary [PDF]
2023 UCD Benefits Brochure [PDF]
2023 UCSD Benefits Brochure [PDF]
2023 UCSF Benefits Brochure [PDF]
2023 UCLA Benefits Brochure [PDF]
2023 UCI Benefits Brochure [PDF]
Forms
2022 Long Term Disability Conversion Form
New York Life AD&D Beneficiary Form
New York Life Group Benefits Claim Form
New York Life How to File a Disability Claim Brochure
New York Life How to File a Life or AD&D Insurance Claim Brochure
New York Life Life Insurance Beneficiary Form
New York Life Life Insurance Claim Form
