Benefits Compliance Documents

Notices

• 2025 Annual Notices
• 2024  Medicare Part D Notice
• Summary of Material Modifications to the 2024 Benefit Plan
• HIPAA Notice of Privacy Practices
• FMLA Notice
• Notice on Health Insurance Marketplace Coverage Options (Healthcare Exchanges)
• SFHCSO Official Notice
• 2024 California Voluntary Disability Plan Notice
• VSP Service Plan Annual Notice

Retirement Plan Participant Disclosures

• USF Defined Contribution Retirement Plan Notice Regarding Default Investment Funds (401a)
• USF Voluntary Retirement Plan 403(b) ERISA Notice
• 2020 USF Voluntary Retirement Plan Auto Enrollment and Default Investment Annual Notice
• TIAA-CREF Lifecycle Funds – Fund Fact Sheet

Summary Plan Descriptions

• USF Defined Contribution Retirement Plan 401(a) Summary Plan Description
• USF Voluntary Retirement Plan 403(b) Summary Plan Description
• USF Emeriti Retirement Health Plan Summary Plan Description
• USF Welfare Benefit Plan Master Summary Plan Description
• Tuition Remission Plan
• 2024 FSA Benefit Resource Summary Plan Description (SPD)
• 2023 FSA Benefit Resource Summary Plan Description (SPD)

Fee Disclosure Information

• 2023 USF Defined Contribution Retirement Plan and Investment Notice (401a)
• 2023 USF Voluntary Retirement Plan and Investment Notice (403b)

Summary Annual Reports

• 2022 Summary Annual Report for the University of San Francisco Defined Contribution Retirement Plan
• 2022 Summary Annual Report for the University of San Francisco Voluntary Retirement Plan 
• 2022 Summary Annual Report for the University of San Francisco Emeriti Retirement Health Plan
• 2022 Summary Annual Report for the University of San Francisco Welfare Benefit Plan

Summary of Benefits and Coverage

• 2024 Anthem Summary of Benefits and Coverage for Health Savings Account (HSA)
• 2024 Anthem Summary of Benefits and Coverage for Modified Premier PPO
• 2024 Anthem PPO Premier Summary of Benefits
• 2024 Anthem Bronze Plan Summary of Benefits
• 2024 Kaiser Summary of Benefits and Coverage for Traditional Plan (Northern CA)
• 2024 Kaiser Summary of Benefits and Coverage for Traditional Plan (Southern CA)
• 2024 Kaiser HMO Summary of Benefits (Northern CA)
• 2024 Kaiser HMO Summary Benefits (Southern CA)
• 2024 Kaiser Chiropractic Benefit Summary Part 1
• 2024 Kaiser Chiropractic Benefit Summary Part 2
• Delta Dental Summary of Benefits - Staff
• Delta Dental Summary of Benefits - Faculty
• 2024 VSP Vision Summary of Benefits
• 2024 FSA Benefit Resource FSA Plan Highlights

Evidence of Coverage and Plan Documents

• 2024 Anthem Evidence of Coverage Premier PPO Plan
• 2024 Anthem Evidence of Coverage Bronze Plan 
• 2024 Kaiser Evidence of Coverage NorCal Plan
• 2024 Kaiser Evidence of Coverage SoCal Plan
• 2024 Kaiser Chiropractic Evidence of Coverage NorCal
• 2024 Kaiser Chiropractic Evidence of Coverage SoCal
• 2024 Voluntary Disability Plan Summary of Coverage
• 2024 Voluntary Disability Plan Statement of Coverage
• 2024 Delta Dental PPO Evidence of Coverage
• New York Life Group Disability Full-time faculty, librarians, staff, and Local 39 Employees
• New York Life Group Basic AD&D Insurance - Class 1 - PHP adjunct faculty
• New York Life Group Basic AD&D Insurance - Class 2 - Full-time faculty, librarians, and staff
• New York Life Group Voluntary AD&D Insurance - Class 2 - Full-time faculty, librarians, and staff
• New York Life Group Voluntary AD&D Insurance - Class 3 - Full-time Local 39 Employees
• New York Life Group Basic Life Insurance - Class 1 - PHP adjunct faculty
• New York Life Group Basic Life Insurance - Class 2 - Full-time faculty, librarians, and staff
• New York Life Group Voluntary Term Life Insurance - Class 2 - Full-time faculty, librarians, and staff
• New York Life Group Voluntary Term Life Insurance - Class 3 - Full-time Local 39 Employees
• 2022 VSP Vision Plan Evidence of Coverage
• 2024 Concern (EAP) Evidence of Coverage