Plan Documents

Plan Documents

Updated 02.27.2024

Material Modification to Plans

Summary of Material Modification to Plan COVID 19 6.1.2020

Medical Plan Documents

2024 Medical & Rx Summary Plan Document 

2024 Medical & Rx Summary Plan Amendment 

2024 HDHP – Summary of Benefits Coverage

2024 HDHP – Summary of Benefits Coverage (Spanish)

2024 PPO – Summary of Benefits Coverage

2024 PPO – Summary of Benefits Coverage (Spanish)

2024 Wrap Plan Document 

Dental Plan Documents

Delta Dental Low Plan SOB eff 07 01 18

Delta Dental High Plan SOB eff 07 01 18

Dental Plan Option Summary

2020 Delta Dental Low Plan

2020 Delta Dental High Plan

Vision Plan Documents

EyeMed Vision Summary of Benefits

401k Plan Documents

Mister Car Wash 401k SPD (Mercer)

Mister Car Wash 401(k) Hardship Withdrawal Amendment 

Life & Disability Plan Documents

Life Insurance Summary

Short Term Disability Summary

Long term Disability Summary

Life Certificate of Coverage

Disability Certificate of Coverage

Required Notices

Transparency in Coverage Final Rules 

Mister Car Wash Exchange Notice 2019

Summary Annual Report 2019

Health Plan Notices 2023-2024

401(k) Summary Annual Report 2020

401(k) Summary Annual Report 2021

No Surprises Act – Balance Billing Disclosure Notice 

Introducing Backup Childcare

Benefits Newsletter -February 2024

Benefits Newsletter - January 2024

Healthcare Made Simple with MyQHealth

Managing Market Volatility