Forms/Docs
Here are the forms, SPDs and legal notices related to your BMO benefits.
Health Care
Medical & HSA
- Consumer Choice Plan Medical SPD (BCBSIL)
- UnitedHealthcare Medical SPD
(Plan terminated 12-31-2021) - Health Savings Account Plan Details
- Kaiser Permanente Colorado HSA Evidence of Coverage
- Kaiser Permanente S. California HSA Evidence of Coverage
- Kaiser Permanente N. California HSA Evidence of Coverage
Spending Accounts
Disability & Life Insurance
Retirement & Savings
401(k) Savings Plan
BMO U.S. Pension Plan
- BMO U.S. Pension Plan SPD
- Employees' Retirement Plan of BancWest Corporation (ERP) SPD Appendix
- United California Bank (UCB) SPD Appendix
Former Pentegra Defined Benefit Plan Participants
Employee Share Purchase Plan
Health Care
Eligibility
Medical & HSA
Prescription Drug
- 2025 Express Scripts National Preferred Formulary (includes exclusions)
- Express Scripts Exclusion List of 2025 Changes
- 2024 Express Scripts National Formulary (includes exclusions)
- 2024 Express Scripts Preventive Drug List
- 2024 Kaiser Regional Formulary Colorado
- 2024 Kaiser Regional Formulary N. California
- 2024 Kaiser Regional Formulary S. California
- 2024 Kaiser Regional Formulary Oregon
Spending Accounts
Health Care
Dependent Care
Voluntary Benefits
Work/Life
Time Off
Additional Forms
Medicare Special Enrollment
2025 Summary of Benefits and Coverage (SBCs)
Health Care
Medical & HSA
- COBRA Continuation of Rights
- Creditable Coverage Notice
- Employee Rights Under FMLA
- Health Plan Notice of Nondiscrimination
- HIPAA Notice of Privacy Practices
- VSP Notice of Privacy Practices
- Marketplace Health Insurance Coverage Options Notice
- Notice of Special Enrollment Rights
- Medicaid and the Children’s Health Insurance Program (CHIP)
- Women’s Health and Cancer Act of 1998
- Notice for Illinois Employees
Life Insurance
Retirement & Savings
2024 Summary of Benefits and Coverage (SBCs)
Kaiser
- 2024 Consumer Choice Plan Kaiser Colorado
- 2024 Consumer Choice Plan Kaiser California
- 2024 Consumer Choice Plan Kaiser Northwest
- 2023 Kaiser Permanente California HMO
- 2023 Kaiser Permanente California HSA
- 2023 Kaiser Permanente Colorado HMO
- 2023 Kaiser Permanente Colorado HSA
- 2023 Kaiser Permanente Northwest HMO
- 2023 Kaiser Permanente Northwest HSA
Legacy Bank of the West
Evidence of Coverage
- 2023 Kaiser Permanente N. California HMO
- 2023 Kaiser Permanente N. California HSA
- 2023 Kaiser Permanente S. California HMO
- 2023 Kaiser Permanente S. California HSA
- 2023 Kaiser Permanente Colorado HMO
- 2023 Kaiser Permanente Colorado HSA
- 2023 Kaiser Permanente Northwest HMO
- 2023 Kaiser Permanente Northwest HSA