Santa Clara University

Human Resorces

Summary Plan Documents

Insured Plans

Name of Plan Plan Number Plan Year Ends Insurer Policy Number Format
Santa Clara University
Group Medical Care Plan
501 12/31 Blue Cross HMO (Plus) 175028H001 PDF
522KB
Santa Clara University
Group Medical Care Plan
501 12/31 Blue Cross HMO (Standard) 175028H001 PDF
521KB
Santa Clara University
Group Medical Care Plan
501 12/31 Blue Cross PPO
(HIA)
175028 PDF
532KB
Santa Clara University
Group Medical Care Plan
501 12/31 Blue Cross PPO
(HSA)
175028 PDF
519KB
Santa Clara University
Group Medical Care Plan
501 12/31 Kaiser Foundation
Health Plan
(Plus, non-union)
979 PDF
629KB
Santa Clara University
Group Medical Care Plan
501 12/31 Kaiser Foundation
Health Plan
(Standard, non-union)
979 PDF
635KB
Santa Clara University
Delta Dental PPO Plan
501 12/31 Delta Dental 4224-0005 PDF
568KB
Santa Clara University
Group Medical and Dental Care Plan
501 12/31/07 Blue View 12081648 PDF
257KB
Santa Clara University
Welfare Benefit Plan
501 12/31 MHN N/A Coming soon!
Santa Clara University
Long-Term Disability Plan
501 12/31 Anthem 104767-1-G PDF
356KB
Santa Clara University
Employee Term Life, Accidental Death and Dismemberment and Dependents Term Life coverage...
501 12/31 Anthem 104767-1-G PDF
272KB


Pension Plans

Name of Plan Plan Number Plan Year Ends Type of Plan Format
Santa Clara University
Tax-Deferred Annuity Plan - 403(b)
001 12/31 Tax-Deferred Annuity Coming soon!
Santa Clara University
Defined Contribution Retirement Plan - 401(a)
002 12/31 Defined Contribution PDF
144KB

ERISA Information

Your plan has been established under the guidelines of ERISA (Employee Retirement Income Security Act of 1974). ERISA requires that certain disclosures be made to plan participants.

What are my rights?

As a participant in certain of the various employee benefit plans maintained by Santa Clara University and described in this handbook, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants will be entitled to:

What Are the Duties of the Operators of the Plan?

In addition to creating rights for plan participants, ERISA imposes duties upon the people responsible for the operation of the plan:

Claims Appeal and Review Process

Under ERISA, there are steps you can take to enforce the above rights. For example, if you request materials from the plan administrator in writing on any of the covered plans and do not receive them within 30 days, you may file suit in a federal court.

In such case, the court may require the plan administrator to provide the materials and pay you up to $100 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the plan administrator.

If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. If it should happen that plan fiduciaries misuse the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the US Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees; for example, if the court finds your claim is frivolous.

If you have any questions about your benefits under any of the ERISA-covered Santa Clara University plans, contact the Benefits Office. If you have any questions about this statement or about your rights under ERISA, contact the nearest area office of the U.S. Labor-Management Services Administration, Department of Labor.

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Plan Sponsor

President & Board of Trustees Santa Clara College
dba Santa Clara University
Santa Clara, CA 95053

Plan Administrator

Human Resources

Agent for Service of Legal Process

Human Resources,
Santa Clara University,
Santa Clara, CA 95053

Employer Identification Number

94-1156617

Source of Funding

The plans are funded by both employee and Santa Clara University contributions. Contributions required of employees are determined by Santa Clara University and are subject to periodic change.

Review of Legal Documents

If you wish to review or obtain copies of the legal documents for these plans, you may do so by contacting the plan administrator. In addition, you may request a copy of Form 5500, which Santa Clara University files with the Department of Labor each year. This form describes the financial condition of each plan. If you wish to correspond with a government agency regarding these plans, you should refer to the employer identification number and plan number.

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500 El Camino Real Santa Clara, California 95053-0850 | (408) 554-4392