Compliance - Plan Documents
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Dental
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Vision
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General Benefit Documents
Pulmonx Benefit Documents
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2024 Plan Year
​2024 Pulmonx Benefits Guide
2024 Pulmonx Benefit Premium Rates
Pulmonx Corporation Health & Welfare Plan Document​
​2024 Pulmonx Corporation Health and Welfare Wrap Summary Plan Description (SPD)
This WRAP/SPD and the underlaying carrier plan documents (components) posted here constitute the full plan document.
​2024 Flexible Spending Account SPD
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Cigna Medical Plans
2025
2024
Cigna OA-20
2024 Cigna OA-20 Summary of Benefits & Coverage
2024 Cigna OA-20 Benefit Summary
2024 Cigna OA-20 Evidence of Coverage
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Cigna PPO 15-250
​2024 Cigna PPO 15-250 Summary of Benefits & Coverage
2024 Cigna PPO 15-250 Benefit Summary
2024 Cigna PPO 15-250 Evidence of Coverage
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Cigna PPO 25-750
​2024 Cigna PPO 25-750 Summary of Benefits & Coverage
2024 Cigna PPO 25-750 Benefit Summary
2024 Cigna PPO 25-750 Evidence of Coverage
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Cigna HDHP PPO $1,600 Deductible
​2024 Cigna HDHP PPO $1,600 Deductible Summary of Benefits & Coverage
2024 Cigna HDHP PPO $1,600 Deductible Benefit Summary
2024 Cigna HDHP PPO $1,600 Deductible Evidence of Coverage
Cigna OA-20
2024 Cigna OA-20 Summary of Benefits & Coverage
2024 Cigna OA-20 Benefit Summary
2024 Cigna OA-20 Evidence of Coverage
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Cigna PPO 15-250
​2024 Cigna PPO 15-250 Summary of Benefits & Coverage
2024 Cigna PPO 15-250 Benefit Summary
2024 Cigna PPO 15-250 Evidence of Coverage
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Cigna PPO 25-750
​2024 Cigna PPO 25-750 Summary of Benefits & Coverage
2024 Cigna PPO 25-750 Benefit Summary
2024 Cigna PPO 25-750 Evidence of Coverage
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Cigna HDHP PPO $1,600 Deductible
​2024 Cigna HDHP PPO $1,600 Deductible Summary of Benefits & Coverage
2024 Cigna HDHP PPO $1,600 Deductible Benefit Summary
2024 Cigna HDHP PPO $1,600 Deductible Evidence of Coverage
Cigna Pharmacy Benefits
​2024 Cigna Drug Advantage 4-Tier Formulary Drug List
View Summary of Formulary Changes effective July 1, 2024
Kaiser Medical Plans
2024
Kaiser Traditional HMO (CA Only)
​2024 Kaiser HMO Summary of Benefits & Coverage
2024 Kaiser HMO Copay Benefit Summary
2024 Kaiser HMO Evidence of Coverage
2024 Kaiser HMO Evidence of Coverage Chiropractic- Acupuncture
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Kaiser HSA-Qualified HDHP HMO (CA Only)
​2024 Kaiser HDHP HMO $1,600 Summary of Benefits & Coverage
2024 Kaiser HDHP HMO $1,600 Benefit Summary
2024 Kaiser HDHP HMO $1,600 Evidence of Coverage
2024 Kaiser HDHP HMO $1,600 Evidence of Coverage Chiropractic- Acupuncture
Kaiser Pharmacy Benefits
Additional Programs and Resources
VSP Vision Plan
Additional Programs and Resources
Tax Advantaged Accounts (through Igoe)
2024 Tax Advantage Accounts Overview
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​Health Savings Account (HSA)
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​Health Care Flexible Spending Accounts (FSAs)
​General Health Care FSA Overview
General Health Care FSA Information and Eligible Expenses
Complete List of Health Care FSA Eligible Expenses
​Limited Purpose Health Care FSA Overview
Limited Purpose Health Care FSA Information and Eligible Expenses
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Dependent Care Flexible Spending Account (FSA)
​Dependent Care FSA Overview
Dependent Care FSA Information and Eligible Expenses
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Commuter Benefit Accounts
​​Transit Benefits Overview
Income Protection Plans (through Lincoln Financial Group)
Basic Life and AD&D
​2024 Basic Life and AD&D Plan Summary
2024 Basic Life and AD&D Evidence of Coverage
​Short Term Disability (STD)​​
2024 STD Evidence of Coverage​
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Long Term Disability (LTD)​
Retirement - 401k Savings Plan (through Empower Retirement)
Employee Assistance Programs