Medical, Vision, and Dental Plan Information

Deductible Plan: Aetna

2026:

• 2026 Summary of Benefits and Coverage (SBC) (PDF)
• 2026 Summary Plan Descriptions (SPD) (Available 2026 Q1)  

2025:

• 2025 Summary of Benefits and Coverage (SBC) (PDF)
• 2025 Summary Plan Descriptions (SPD) 

High Deductible Health Plan: Aetna

2026:

• 2026 Summary of Benefits and Coverage (SBC) (PDF)
• 2026 Summary Plan Descriptions (SPD) (PDF) (Available 2026 Q1)  

2025:

• 2025 Summary of Benefits and Coverage (SBC) (PDF)
• 2025 Summary Plan Descriptions (SPD) (PDF) 

LEOFF Retiree Plan: Aetna

2026:

• 2026 Summary of Benefits and Coverage (SBC) (PDF)
• 2026 Summary Plan Descriptions (SPD) (PDF) (Available 2026 Q1)

2025:

• 2025 Summary of Benefits and Coverage (SBC) (PDF)
• 2025 Summary Plan Descriptions (SPD) (PDF)

General Resources

• Behavioral Health AbleTo Support (PDF)
• Behavioral Health Infosheet (PDF)
• Televideo Services (PDF)
• Hinge Health Flyer (PDF)
• Transform Oncology (PDF)
• Facts About Menopause and Resources (PDF)
• Aetna Enhanced Maternity Program Pregnancy Handbook (PDF)
• Aetna Enhanced Maternity Member Flyer (PDF)
• Find A Provider | Instructions (PDF)
• Transition of Care Form (PDF)

Preventive Services

The plan pays 100% of the cost of qualified preventive services provided in-network, and some generic preventative drugs are available with no copay, deductible, or coinsurance. Please refer to Aetna.com for a complete and up-to-date drug listing.

• Preventive Care Coverage (PDF)

Teledoc Resources

• Teledoc - Talk to a Doctor Anytime, Anywhere by Phone or Video
• Set Up Teledoc in 4 Easy Steps (PDF)
• Teledoc – Now Including Behavioral Health and Dermatology (PDF)
• Teledoc FAQ (PDF)

Consolidated Appropriation Act – Transparency in Coverage

In compliance with the Consolidated Appropriations Act, 2021 (CAA), Aetna is providing machine-readable files with in-network rate and allowed amount data. The file is updated monthly.

• Aetna Machine Readable Files (MRFs)

Pharmacy Benefits Manager (PBM) for Deductible and High Deductible Health Plans: AffirmedRx

AffirmedRx Resources/Flyers

Note: The resources below are standard lists provided by AffirmedRx. Port-specific information and resources will be added as they become available.

• Formulary Drug List (i.e., list of covered prescriptions)
• Pharmacy Network Search
• AffirmedRx Member FAQ (PDF)
• AffirmedRx App Flyer (PDF)

Mail Order Prescription Information

• Amazon (PDF)
• CenterWell (PDF)
• CostPlus (PDF)

Health Management Organization (HMO): Kaiser 

2026:

• 2026 Summary of Benefits and Coverage (SBC) (PDF)
• 2026 Summary Plan Descriptions (SPD) (Available 2026 Q1) 

2025:

• 2025 Summary of Benefits and Coverage (SBC) (PDF)
• 2025 Summary Plan Descriptions (SPD) (PDF) 

Mental Health and Wellness

• Mental Health and Wellness Brochure (PDF)
• Mental Health and Wellness FAQ (PDF)

Dental Care: Delta Dental

2026:

• 2026 Legacy Plan 00201 Summary (PDF)
• 2026 Core and Enhanced Plan 09201 Summary (PDF)
• LEOFF Plan 09521 Summary (PDF)

2025:

• 2025 Legacy Plan 00201 Summary (PDF)
• 2025 Core and Enhanced Plan 09201 Summary (PDF)
• LEOFF Plan 09521 Summary (PDF)

Delta Dental Resources/Flyers

• How to Find A Dentist (PDF)
• The MySmile App Has Its Perks (PDF)
• Virtual Dentistry (PDF)

1-800-877-7195
VSP

Vision Care: VSP

2026:

• 2026 Summary of Benefits (PDF) 

2025:

• 2025 Summary of Benefits (PDF) 

VSP Resources/Flyers

• Frequently Asked Questions (PDF)
• What to Expect during an Eye Exam (PDF)
• Keep Your Eyes Healthy for Life (PDF)
• Browse with Benefits (PDF)
• Exclusive Member Extras (PDF)
• Members Save More at VisionWorks (PDF)
• TruHearing Hearing Aid Discount (PDF)

1-844-729-3539
Inspira

Flexible Spending Accounts and Health Savings Accounts: Inspira

• Information about Flexible Spending Accounts, including common eligible expenses
• Information about Dependent Care Flexible Spending Accounts, including common eligible expenses
• Information about Health Savings Accounts, including common eligible expenses
• IRS Publication 969, Health Savings Accounts

Info Sheets

• Flexible Spending Accounts and Dependent Care FSAs (PDF)
• Health Savings Accounts (PDF)
• Limited Flexible Spending Accounts (PDF)
• HSA Custodial Agreement (PDF)