Plan Documents and Forms
2025–2026 Benefit Year Documents
2025–2026 UCD Benefits Brochure [PDF]
2025–2026 UCSF Benefits Brochure [PDF]
2025–2026 UCLA Benefits Brochure [PDF]
2025–2026 UCSD Benefits Brochure [PDF]
2025–2026 UCI Benefits Brochure [PDF]
2025–2026 UCR Benefits Brochure [PDF]
2025 Anthem PPO Medical Plan Benefits Summary [PDF]
2025 Anthem HMO Medical Plan Benefits Summary [PDF]
2025 Anthem PPO Summary of Benefits and Coverage [PDF]
2025 Anthem HMO Summary of Benefits and Coverage [PDF]
New York Life AD&D (Non-U.S. Citizen) Benefit Summary [PDF]
New York Life AD&D (U.S. Citizen) Benefit Summary [PDF]
New York Life Life Insurance (Non-U.S. Citizen) Benefit Summary [PDF]
New York Life Life Insurance (U.S. Citizen) Benefit Summary [PDF]
New York Life Long-Term Disability (Non-U.S. Citizen) Benefit Summary [PDF]
New York Life Long-Term Disability (U.S. Citizen) Benefit Summary [PDF]
New York Life Short-Term Disability (Non-U.S. Citizen) Benefit Summary [PDF]
New York Life Short-Term Disability (U.S. Citizen) Benefit Summary [PDF]
New York Life Short-Term Disability (U.S. Citizen) Evidence of Coverage [PDF]
New York Life Short-Term Disability (Non-U.S. Citizen) Evidence of Coverage [PDF]
New York Life Long-Term Disability (U.S. Citizen) Evidence of Coverage [PDF]
New York Life Long-Term Disability (Non-U.S. Citizen) Evidence of Coverage [PDF]
New York Life Life Insurance (U.S. Citizen) Evidence of Coverage [PDF]
New York Life Life Insurance (Non-U.S. Citizen) Evidence of Coverage [PDF]
New York Life Accident Insurance (U.S. Citizen) Evidence of Coverage [PDF]
New York Life Accident Insurance (Non-U.S. Citizen) Evidence of Coverage [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
