Summary Plan Descriptions

Benefits Plan Documents and Plan Summaries

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. Please review this information carefully. If you have questions, need additional information, or wish to request a paper copy of the SPDs free of charge, please contact the Office of Benefits and Wellness at 410-617-1365.

Benefit Plan	Insurer or Claims Administrator	Title of Benefit Booklet, Guide or Certificate
Health and Welfare Benefit Plan Wrap Document H&W Wrap Document Appendix July 2020 H&W Wrap Document Appendix July 2023	Loyola University Maryland, 4501 N Charles Street, Baltimore MD 21210	Loyola University Maryland Health & Welfare Benefit Plan
Medical OAP Plan OAP Certificate Rider OAP Certificate Rider MA OAP Compliance Rider Summary of Benefits and Coverage "SBC" Benefits Summary	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus Medical Benefits
Medical OAP-IN Plan Vision Benefit Certificate OAP-IN Certificate Rider OAP-IN Certificate Rider MA OAP-IN Compliance Rider Summary of Benefits and Coverage "SBC" Benefits Summary	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus In Network Medical Benefits
Medical OAP HDHP Plan Vision Benefit Certificate OAP HDHP Certificate Rider MA OAP HDHP Compliance Rider Summary of Benefits and Coverage "SBC" Benefits Summary	Cigna Health and Life Insurance Company Hartford, CT 06152	Open Access Plus Medical Benefits, Qualified High Deductive Health Plan
Supplemental Benefits Accident Insurance Critical Illness Insurance Hospital Indemnity	Cigna Health and Life Insurance Company Hartford, CT 06152	Summary of Benefits
Dental PPO Dental Certificate Rider - LDA Dental Certificate Addendum Certificate Rider Certificate Rider Certificate Rider	Metropolitan Life Insurance Company 200 Park Avenue New York, NY 10166	Your Employee Benefit Plan Dental Expense Benefits PPO Dental Plan
Dental Copay Plan Dental Certificate Rider - LDA Dental Certificate Addendum Certificate Rider Certificate Rider Certificate Rider	Metropolitan Life Insurance Company 200 Park Avenue New York, NY 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
Core Life Insurance/Accidental Death and Dismemberment Class 1 (Benefit Limit $ 50,000)	Symetra Life Insurance Company 777 108th Ave., NE, Suite 1200 Bellevue, WA 98004-5135	Group Term Life, AD&D, Supplemental Life, and Dependent Life Certificate of Insurance for Employees Capping the Benefit Amount to $ 50,000
Core Life Insurance/Accidental Death and Dismemberment, Supplemental Life, and Dependent Life Class 2	Symetra Life Insurance Company 777 108th Ave., NE, Suite 1200 Bellevue, WA 98004-5135	Group Term Life, AD&D, Supplemental Life, and Dependent Life Certificate of Insurance for Employees Electing the Maximum Benefit Amount of $ 250,000
Core and Buy-up Long-Term Disability Insurance Class 1 – Non 403b	Symetra Life Insurance Company 777 108th Ave., NE, Suite 1200 Bellevue, WA 98004-5135	Core and Buy-up LTD Insurance for Employees Not Receiving Loyola's 403b Contribution
Core and Buy-up Long-Term Disability Insurance Class 2 – 403b Participant	Symetra Life Insurance Company 777 108th Ave., NE, Suite 1200 Bellevue, WA 98004-5135	Core and Buy-up LTD Insurance for Employees Receiving Loyola's 403b Contribution
Employee Assistance Program	Acentra Health 777 East Park Drive Harrisburg, PA 17111	Employee Assistance Program
Flexible Spending Accounts	Optum Financial 307 International Circle, Suite 200 Hunt Valley, MD 21030	Health Care and Dependent Care Flexible Benefits Plan Summary Plan Description
Loyola University Maryland Retirement Plan	TIAA P.O. Box 1273 Charlotte, NC 28201	Summary Plan Description

The information on this site is provided for general reference and may be updated or changed at any time. The University reserves the right to modify, amend, suspend, or discontinue policies or programs without prior notice.

While every effort has been made to ensure accuracy, in the event of any discrepancy, the official policy documents will govern. Please rely on the written descriptions in the policy manual, as oral explanations are not binding. Employees should contact the Office of People and Culture or the appropriate administrator for the most current and authoritative guidance.

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