Welcome to Master Benefit Documentation
Click below to download the Summary Plan Description/125/Wrap PDF file(s).
- SPD Tandem HR Health Welfare Benefits Plan 2023
- Tandem HR Welfare Benefits Plan 2023 Restatement
- SPD Tandem HR Health Welfare Benefits Plan 2022
- SPD Tandem HR Health Welfare Benefits Plan 2022-1
- Tandem Professional Employer Services Inc. Section 125 Plan
- Tandem Professional Employer Services Inc. Section 125 Plan for Account-Based Benefits
Click below to download the Summary of Benefits and Coverage PDF file(s).
Documentation for plan year 9/1/2024 – 8/31/2025
Blue Cross and Blue Shield of Illinois:
- MIBAH2010 Blue Advantage HMO $10 Copay
- MIBAH2020 Blue Advantage HMO $20 Copay
- MIBAV2110 Blue Advantage HMO Value Choice $40 Copay
- MIBAV2120 Blue Advantage HMO Value Choice $50 Copay
- MIBCO2000 Blue Choice Options $500-$1500
- MIBCO2040 Blue Choice Options $1500-$4500
- MIBCS2120 Blue Choice Select PPO $2500
- MIBPP2060 BluePrint PPO $1000
- MIBPP2080 BluePrint PPO $1500
- MIBPP2130 BluePrint PPO $2500
- MIBPP2170 BluePrint PPO $5000
- MICOE4064 Blue Choice Options $3200-$9200
- MIEEE3083 BlueEdge HSA $6000
- MIEEE4044 BlueEdge HSA $3200-$3200
- MIEEE4064 BlueEdge HSA $3200-$6200
Blue Cross and Blue Shield of Texas:
- MTBCB038 BC PPO 5000 2024
- MTBCP002 BC PPO 500 2024
- MTBCP011 BC PPO 1000 2024
- MTBCP012H BC HSA 5000 2024
- MTBCP019 BC PPO 2000 2024
- MTBCP026 BC PPO 3000 2024
- MTBCP318H BC HSA 3100 2024
- MTBEE011 BE HMO 1000 2024
- MTBEE027 BE HMO 3000 2024
- MTBEE040 BE HMO 5000 2024
- MTBPA007H BPA HMO HSA 5000 2024
- MTBPA025 BPA HMO 3000 2024
Aetna:
- CMed Indemnity 1,000-80% – 081200-010020-032403
- EPO OA 1,000 70% – 081200-010020-022464
- EPO OA 1,500 100% – 081200-010020-022467
- EPO OA 3,000 100% – 081200-010020-022470
- EPO OA 5,000 100% – 081200-010020-022471
- EPO OA 6,350 100% – 081200-010020-022478
- EPO OA 20 100% – 081200-010020-022457
- EPO OA 30 70% – 081200-010020-022461
- EPO OA HDHP 3,500 80% – 081200-010020-022493
- EPO OA HDHP 5,000 80% – 081200-010020-022494
- EPO OA HDHP 6,000 80% – 081200-010020-032402
- OAMC 1,000 80% – 081200-010020-022435
- OAMC 1,500 70% – 081200-010020-022436
- OAMC 2,000 80% – 081200-010020-022443
- OAMC 3,000 70% – 081200-010020-022446
- OAMC 5,000 70% – 081200-010020-022451
- OAMC 750 90% – 081200-010020-022432
- OAMC HDHP 3,250 90% – 081200-010020-022479
- OAMC HDHP 4,000 80% – 081200-010020-022480
- OAMC HDHP 6,350 100 – 081200-010020-022490
- PPO 1,000 80% – 081200-010020-032404
- PPO 2,000 80% – 081200-010020-032409
- PPO 5,000 70% – 081200-010020-032414
- PPO HDHP 3,250 90% – 081200-010020-032415
Guardian:
- Accident Advantage Plan Summary
- Accident Premier Plan Summary
- Basic Life 1x salary Plan Summary
- Basic Life 2x salary Plan Summary
- Basic Life 20k Plan Summary
- Basic Life 25k Plan Summary
- Basic Life 50k Plan Summary
- Critical Illness Plan Summary
- Dental High Plan – TX Summary
- Dental High Plan Plan Summary
- Dental HMO Plan Summary
- Dental Low Plan – TX Summary
- Dental Low Plan Plan Summary
- EAP FAQs for Managers
- Employee Assistance Brochure
- Global Travel Assistance Benefits_EAP
- Hospital Indemnity Plan Summary
- LTD Option 1 Plan Summary
- LTD Option 2 Plan Summary
- LTD Option 3 Plan Summary
- LTD Option 4 Plan Summary
- LTD Option 5 Plan Summary
- LTD Option 6 Plan Summary
- LTD Option 7 Plan Summary
- LTD Option 8 Plan Summary
- STD Option 1 Plan Summary
- STD Option 2 Plan Summary
- STD Option 3 Plan Summary
- STD Option 4 Plan Summary
- STD Option 5 Plan Summary
- STD Option 6 Plan Summary
- STD Option 7 Plan Summary
- STD Option 8 Plan Summary
- Vision High Plan – TX Summary
- Vision High Plan Summary
- Vision Low Plan – TX Summary
- Vision Low Plan Summary
- Voluntary Life Plan Summary
Quartz:
- HMO 750
- HMO 1500
- HMO 2000
- HMO 6000
- POS 300
- POS 750
- POS 1500
- POS 2000
- POS 6000
- PPO 300
- PPO 750
- PPO 1500
- PPO 2000
- PPO 6000
Documentation for plan year 9/1/2023 – 8/31/2024
Blue Cross and Blue Shield of Illinois:
- BCBSIL – MIBAH2010 HMOI
- BCBSIL – MIBAH2020
- BCBSIL – MIBAV2110
- BCBSIL – MIBAV2120
- BCBSIL – MIBCO2000
- BCBSIL – MIBCO2040
- BCBSIL – MIBCS2120
- BCBSIL – MIBPP2060
- BCBSIL – MIBPP2080
- BCBSIL – MIBPP2130
- BCBSIL – MIBPP2170
- BCBSIL – MICOE3063
- BCBSIL – MIEEE3063
- BCBSIL – MIEEE3083
- BCBSIL -MIEEE3043
Blue Cross and Blue Shield of Texas:
- BCBSTX- MTBCB038 BC PPO 5000
- BCBSTX- MTBCP002 BC PPO 500
- BCBSTX- MTBCP011 BC PPO 1000
- BCBSTX- MTBCP012H BC HSA 5000
- BCBSTX- MTBCP019 BC PPO 2000
- BCBSTX- MTBCP026 BC PPO 3000
- BCBSTX- MTBCP318H BC HSA 3100
- BCBSTX- MTBEE011 BE HMO 1000
- BCBSTX- MTBEE027 BE HMO 3000
- BCBSTX- MTBEE040 BE HMO 5000
- BCBSTX- MTBPA007H BPA HMO HSA 5000
- BCBSTX- MTBPA025 BPA HMO 3000
Quartz:
- Quartz- HMO 300
- Quartz- HMO 750
- Quartz- HMO 1500
- Quartz- HMO HSA 2000
- Quartz- HMO HSA 6000
- Quartz- POS 300
- Quartz- POS 750
- Quartz- POS 1500
- Quartz- POS HSA 2000
- Quartz- POS HSA 6000
- Quartz- PPO 300
- Quartz- PPO 750
- Quartz- PPO 1500
- Quartz- PPO HSA 2000
- Quartz- PPO HSA 6000
Aetna:
- CMed Indemnity 1,000-80%
- EPO OA 1,000 70%
- EPO OA 1,500 100%
- EPO OA 3,000 100%
- EPO OA 5,000 100%
- EPO OA 6,350 100%
- EPO OA 20 100%
- EPO OA 30 70%
- EPO OA HDHP 3,500 80%
- EPO OA HDHP 5,000 80%
- EPO OA HDHP 6,000 80%
- OAMC 1,000 80%
- OAMC 1,500 70%
- OAMC 2,000 80%
- OAMC 3,000 70%
- OAMC 5,000 70%
- OAMC 750 90%
- OAMC HDHP 3,250 90%
- OAMC HDHP 4,000 80%
- OAMC HDHP 6,350 100
- PPO 1,000 80%
- PPO 2,000 80%
- PPO 5,000 70%
- PPO HDHP 3,250 90%
Guardian:
- Accident Advantage Plan Summary
- Accident Premier Plan Summary
- Basic Life 1x salary Plan Summary
- Basic Life 2x salary Plan Summary
- Basic Life 20k Plan Summary
- Basic Life 25k Plan Summary
- Basic Life 50k Plan Summary
- Critical Illness Plan Summary
- Dental High Plan – TX Summary
- Dental High Plan Plan Summary
- Dental HMO Plan Summary
- Dental Low Plan – TX Summary
- Dental Low Plan Plan Summary
- EAP FAQs for Managers
- Employee Assistance Brochure
- Global Travel Assistance Benefits_EAP
- Hospital Indemnity Plan Summary
- LTD Option 1 Plan Summary
- LTD Option 2 Plan Summary
- LTD Option 3 Plan Summary
- LTD Option 4 Plan Summary
- LTD Option 5 Plan Summary
- LTD Option 6 Plan Summary
- LTD Option 7 Plan Summary
- LTD Option 8 Plan Summary
- STD Option 1 Plan Summary
- STD Option 2 Plan Summary
- STD Option 3 Plan Summary
- STD Option 4 Plan Summary
- STD Option 5 Plan Summary
- STD Option 6 Plan Summary
- STD Option 7 Plan Summary
- STD Option 8 Plan Summary
- Vision High Plan – TX Summary
- Vision High Plan Summary
- Vision Low Plan – TX Summary
- Vision Low Plan Summary
- Voluntary Life Plan Summary
Click below to download the Summary Annual Reports PDF file(s).
- 2023 SAR – QTI – 508
- 2023 SAR – Tandem Sec 125 – 501
- 2023 SAR – Short Year – Midwest Sec 125 – 506
- 2023 SAR – Short Year – Tandem Health Welfare – 503
- 2023 SAR – Short Year – Tandem Welfare – 502
- 2022 SAR – Midwest Vol Ins – 505
- 2022 SAR – Midwest Vision – 504
- 2022 SAR – Midwest Dental – 502
- 2022 SAR – Midwest Medical – 501
- 2022 SAR – Midwest Sec 125 – 506
- 2022 SAR – QTI – 508
- 2022 SAR – Tandem Health Welfare – 503
- 2022 SAR – Tandem Sec 125 – 501
- 2022 SAR – Tandem Welfare – 502
Click below to download the Certificate of Insurance PDF file(s).