Forms & Resources
MIT Notices
- SCMA MIT HIPAA Notice of Privacy Practices
- SCMA MIT HIPAA Authorization for Use or Disclosure of PHI
To allow use or disclosure of your protected health information, please complete MIT’s Authorization For Use Or Disclosure Of Protected Health Information Form.
Print, sign, and email to MITinfo@scmedical.org.
Summary Plan Documents
2026 Benefit Plan Year
- SCMA MIT 2026 Summary Plan Description – Effective 1/1/2026
- Medical Coverages
- Dental Coverage (Basic)
- Dental Coverage (Enhanced)
- Embedded Benefit (Basic Life Insurance) – Certificate of Insurance
- Embedded Benefit (Accident) – Certificate of Insurance
- Embedded Benefit (Critical Illness) – Certificate of Insurance
2025 Benefit Plan Year
Click Here to order a paper copy of the Summary Plan Description that describes what the plan provides and how it operates including our medical and dental plans.
Summary of Benefits and Coverage
Plans (2026)
High Deductible Plans
Major Medical Plans
Specialty Plans
Plans (2025)
High Deductible Plans
Major Medical Plans
Specialty Plans
Total Trust Perks (Embedded Benefits)
Virtual Care
Embedded Insurance (2026)
Sun Life Basic Life Insurance
- Sun Life Basic Life Benefit Highlights
- Sun Life Basic Life – How to File a Claim
- Sun Life Claimant Life Insurance Form
- Sun Life Insurance Beneficiary Form
Sun Life Accident Insurance
- Sun Life Accident Insurance Benefit Highlights
- Sun Life Accident Insurance – How to File a Claim
- Sun Life Accident Insurance Claim Form
Sun Life Critical Illness Insurance
- Sun Life Critical Illness Benefit Highlights
- Sun Life Critical Illness – How to File a Claim
- Sun Life Critical Illness Claim Form
Sun Life Accident and Critical Wellness Benefit
Other Related Benefits (2026)
- Sun Life Life Insurance – Portability vs Conversion
- Sun Life Critical Illness Insurance Portability Process
- Sun Life Accident Insurance Portability Process
- BSA Care Management Programs
- Sun Life Wellthy (End of Life Navigation Support)
- Sun Life Global Emergency Assistance
Embedded Insurance (2025)
- The Hartford Basic Life and AD&D Benefit Highlights
- The Hartford Short Term Disability Benefit Highlights
- The Hartford Basic Life and AD&D Benefit Plan (Physician)
- The Hartford Basic Life, AD&D, and Short Term Disability Benefit Plan (Non-physician)
Other Related Benefits (2025)
- The Hartford Ability Assist Counseling
- The Hartford Beneficiary Assist Counseling
- The Hartford Estate Planning Services
- The Hartford Funeral Concierge Services
- The Hartford Travel Assist and ID Theft Protection
MIT Supplemental Insurance Benefits
Community Eye Care (CEC)
Sun Life (2026)
Sun Life Voluntary Life and AD&D Insurance
- Voluntary Life and AD&D Benefit Highlights
- How to File a Claim
- Claimant Life Insurance Form
- Insurance Beneficiary Form
- Voluntary Life – Certificate of Insurance
- AD&D – Certificate of Insurance
Sun Life Voluntary Accident Insurance
Sun Life Voluntary Critical Illness Insurance
- Voluntary Critical Illness Insurance Benefit Highlights
- How to File a Claim Form
- Critical Illness Claim Form
Sun Life Accident and Critical Illness Wellness Benefit
The Hartford (2025)
The Hartford Voluntary Life and AD&D Insurance
- Voluntary Life and AD&D Benefit Highlights
- Voluntary Life and AD&D Benefit Plan (Physicians)
- Voluntary Life and AD&D Benefit Plan (Non-Physicians)
The Hartford Voluntary Accident Insurance
- Accident Insurance Benefit Highlights
- Accident Insurance Benefit Plan
- How to File an Accident Prevention Benefit
The Hartford Voluntary Critical Illness Insurance
- Critical Illness Insurance Benefit Highlights
- Critical Illness Benefit Plan
- How to File a Health Screening Benefit
The Hartford Voluntary Hospital Indemnity Insurance
Forms
MIT and MIT Partner Affiliated Forms
- Members’ Insurance Trust Enrollment/Change
- Waiver of Coverage
- Sun Life Beneficiary
- Sun Life Insurance Claim
- Sun Life Accident Insurance Claim
- Sun Life Critical Illness Insurance Claim
- Sun Life Online Evidence of Insurability (EOI)
- Sun Life – How to File a Wellness Benefit Claim
- SCMA Automatic Draft Authorization (ACH)
- MIT Automatic Draft Authorization (ACH)
- CEC Vision Out of Network Claim
- BSA International Claim Form
Claim Forms (For claims prior to January 1, 2025)
MIT Procedures and Partner Resources
MIT Procedures
- Leave of Absence (LOA) Process
- 2026 MIT Benefit Enrollment Guide
- 2026 MIT JET Insure Enrollment Process
MIT’s Benefits and Billing System – JET Insure
MIT Insurance Partners
- Blue Solutions Administrator – Transparency in Coverage
- This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
- Blue Solutions Administrator (BSA) – My Health Toolkit
- Express Scripts (Pharmacy) Portal
- Sun Life (Critical Illness, Accident, Life Insurance) Portal
- Sun Life Dental
- The Hartford
- Planned Administrators Inc (PAI)
- PAI Member Portal (For claims prior to January 1, 2025)
- PAI Member Portal Instructions
