Loyola University Maryland

Office of Human Resources

Summary Plan Descriptions

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LUMD 403b Summary Plan Description

LUMD Retirement Plan Summary of Material Modification Effective August 1, 2016 - Loans

LUMD Health and Welfare

Summary of Benefits 

This chart provides a summary of the benefits available under Loyola University Maryland Health & Welfare Benefit Plan. The benefit guides and insurance certificates listed below provide detailed information on the benefits available and are incorporated by reference into this Summary Plan Description. Please use the list below to identify the incorporated documents for the benefits in which you are enrolled.

Benefit

Insurer or Claims Administrator

Title of Benefit Booklet, Guide or Certificate

Medical and Prescription Drug –PPO

CareFirst of Maryland, Inc.

d/b/a CareFirst BlueCross BlueShield

10455 Mill Run Circle

Owings Mills, Maryland

21117-5559

Preferred Provider Option Evidence of Coverage

Medical and Prescription Drug –HMO

CareFirst of Maryland, Inc.

d/b/a CareFirst BlueCross BlueShield

10455 Mill Run Circle

Owings Mills, Maryland 21117-5559

BlueChoice Evidence of Coverage

Medical and Prescription Drug – Healthy Blue

CareFirst of Maryland, Inc.

d/b/a CareFirst BlueCross BlueShield

10455 Mill Run Circle

Owings Mills, Maryland 21117-5559

Healthy Blue Evidence of Coverage

Dental PPO

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Employee Benefit Plan

Dental Expense Benefits

PPO Dental Plan

Dental Copay Plan

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Benefit Plan

Copay Dental Plan

Core Vision

Mid-Atlantic Vision Service Plan, Inc.

3333 Quality Drive

Rancho Cordova, CA 95670

Group Vision Care Policy

Certificate of Coverage

Vision Buy-up

Mid-Atlantic Vision Service Plan, Inc.

3333 Quality Drive

Rancho Cordova, CA 95670

Group Vision Care Policy

Certificate of Coverage

Basic Life and Accidental Death & Dismemberment Insurance

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Benefit Plan

Basic Life Insurance, Supplemental Life Insurance, Dependent Life Insurance, Accidental Death & Dismemberment Insurance

Supplemental Life Insurance (including coverage for dependents)

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Benefit Plan

Basic Life Insurance, Supplemental Life Insurance, Dependent Life Insurance, Accidental Death & Dismemberment Insurance

Voluntary Long-term Disability Buy-up  Insurance with Retirement

Without Retirement

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Benefit Plan

All Employees Pension Plan or

All Employees Non Pension Plan

Rider - Portability

Long-term Disability Insurance with Retirement

Without Retirement

 

Metropolitan Life Insurance Company

200 Park Avenue

New York, New York 10166

Your Benefit Plan

All Employees Pension Plan or

All Employees Non Pension Plan

Employee Assistance Program

KEPRO

777 East Park Drive

Harrisburg, PA 17111

Employee Assistance Program

Health Care Flexible Spending Accounts

ConnectYourCare

307 International Circle, Suite 200

Hunt Valley, MD 21030

Flexible Benefits Plan Summary Plan Description