Plan & Policy Documents

These Summary Plan and Policy Descriptions are the policy documents for each specific benefit offered by Notre Dame: Medical, Dental, Prescription, Vision, Life Insurance, Retirement, and more. These documents provide certificates of coverage, details on eligibility, exclusions, appeals, and more.

Benefits Plan

• Summary Plan Description for The University of Notre Dame du Lac Group Benefits Plan (PDF)
  This Summary Plan Description (“SPD”) describes employee benefits available to eligible faculty, staff and their families. The benefit plans included are the medical, dental, vision, life, long term disability and long term care benefit plans.
• Flexible Spending Account Amendment 2020 (PDF)
  Due to changes made to IRS regulations, the University has amended its wrap document as it pertains to flexible spending accounts for 2020.

Medical Plans

• Anthem PPO Plan
• Anthem HSA Plan
• Anthem High Deductible with HRA Plan
• Grandfathered Indemnity Plan
• HDHP – Metropolitan Life Accident Contract (PDF)
• HDHP – Metropolitan Life Accident Certificate of Coverage (PDF)
• HDHP – Metropolitan Life Critical Illness Contract (PDF)
• HDHP – Metropolitan Life Critical Illness Certificate of Coverage (PDF)

Cigna Global Health Plan

(For international travel on University business for one semester or longer)

• Cigna Global Health Plan Policy (PDF)
• Cigna Global Health Plan Certificate

Dental Plans

• Delta Dental Plan Certificate (PDF).
  This Certificate, along with your Summary of Dental Plan Benefits (see below), describes the specific benefits of your Delta Dental program and how to use them.
• Delta Dental Premier (PPO) Summary of Benefits (PDF)
• Delta Dental (PPO) POS Summary of Benefits (PDF)

Prescription Drug Benefit

• OptumRX (PDF)

Vision Insurance

• Fidelity Security Life Insurance Company – for EyeMed (PDF)
• EyeMed Vision Care Services Summary (PDF)

Accident Insurance

• HDHP – Metropolitan Life Accident Contract (PDF)
• HDHP – Metropolitan Life Accident Certificate of Coverage (PDF)
• Metropolitan Life Accident Contract (PDF)
• Metropolitan Life Accident Certificate of Coverage (PDF)

Critical Illness Insurance

• HDHP – Metropolitan Life Critical Illness Contract (PDF)
• HDHP – Metropolitan Life Critical Illness Certificate of Coverage (PDF)
• Metropolitan Life Critical Illness Contract (PDF)
• Metropolitan Life Critical Illness Certificate of Coverage (PDF)

Life Insurance

• Minnesota Life (PDF)

Long-Term Care

• Prudential (PDF)

Long-Term Disability

• The Standard (PDF)

Retiree Medical Plans

• Retiree PPO Plan
• Retiree Indemnity Plan

Retirement Programs

• University of Notre Dame 403(b) Retirement Plan (Faculty and Staff) (PDF)
• University of Notre Dame 403(b) Retirement Plan (Choice-Eligible Grandfathered) (PDF)

Pension Plan

• Employees’ Pension Plan (PDF)

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