General

Qualifying Life Event Flyer
Dependent Documentation
VSP Notice of Privacy Practices

Legal Notices

Learn about your rights and responsibilities under the Ingram Industries benefits program.

2024 Legal Notices
2025 Legal Notices
HIPAA Special Enrollment Rights
Wellness Program Legal Notice
Surprise Billing Notice
Illinois Essential Health Benefit
CHIP Model Notice 2024

TPA Disclosure Notice
Prudential has engaged Accenture to provide services to our customers on our behalf. Accenture’s US subsidiary, Accenture Insurance Services, has a regulatory obligation to notify customers that they are acting in the capacity of a Third Party Administrator. 

Summary of Benefits and Coverage (SBC)

Find out what the Medical Plan covers and what you pay for covered services.

Summary of Benefits Coverage – Signature Plan
Summary of Benefits Coverage – Signature Plan CA
Summary of Benefits Coverage – Choice HSA Plan
Summary of Benefits Coverage – Choice HSA Plan CA
Summary of Benefits Coverage – Value HSA Plan
Summary of Benefits Coverage – Value HSA Plan CA

Summary Plan Descriptions (SPD)

Find detailed information about your benefit plans and the rules governing them.

Medical Plan Summary
Retirees Plan Summary
Summary Plan Description – Choice
Summary Plan Description – Signature
Summary Plan Description – Value

Summary of Material Modifications

Notice to Interested Parties
Ingram Marine Group Retirement Plan