Dogwood Village

Below are the Summary of Benefits and Coverage (SBC) for each of Dogwood Village’s sponsored health plans for the plan year from July 1, 2022 – June 30, 2023, as well as additional documents for your review.

SBCs

Gravie Comfort $5000 OOPM
Gravie Comfort $7900 OOPM
Gravie HSA $5000 Ded/$6500 OOPM
Gravie HSA $6350 Ded/$6350 OOPM

Additional Documents

Special Enrollment Notice
Release of Information
Privacy Notice
CHIP Notice
Medicare Part D Notice
Employee Waiver Form

Gravie-HSA-6350-Ded-6350-OOPM-Med-Opt-SPD-2022
Gravie-Comfort-5000-OOPM-Med-Opt-SPD-2022
Gravie-Comfort-7900-OOPM-Med-Opt-SPD-2022
Gravie-HSA-5000-Ded-6500-OOPM-Med-Opt-SPD-2022
PrintVersion Gravie-Comfort-5000-OOPM-Med-Opt-SPDDownload
PrintVersion Gravie-Comfort-7900-OOPM-Med-Opt-SPDDownload
PrintVersion Gravie-HSA-5000-Ded-6500-OOPM-Med-Opt-SPDDownload
PrintVersion Gravie-HSA-6350-Ded-6350-OOPM-Med-Opt-SPDDownload

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