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Summary of Benefits and Coverage: What this - Dean Health 2026

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The document is an Employee Health History Addendum from Dean Health Plan, Inc. It requires employees to provide detailed health information regarding themselves and their dependents, including pregnancy status, tobacco use, history of various medical conditions, treatments received in the past five years, and current medications. The purpose is to gather comprehensive health data for insurance coverage considerations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Employee Name and Group Name at the top of the form. This information is essential for identifying your application.
Proceed to answer each question regarding health history. If you answer 'yes' to any question, provide detailed information as requested in the subsequent fields.
For questions related to specific health conditions, check all applicable boxes and provide additional details in the space provided below each question.
If you have taken any medications, list them along with dosages and the conditions they treat. Ensure that all relevant information is included for clarity.
Finally, sign and date the form at the bottom to confirm that all information provided is accurate and complete.

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What is a summary of benefits and coverage?

The SBC is a snapshot of a health plans costs, benefits, covered health care services, and other features that are important to consumers. SBCs also explain health plans unique features like cost sharing rules and include docHub limits and exceptions to coverage in easy-to- understand terms.