Forms/Docs
Here are the SPDs, SBCs, forms, and legal notices related to your BMO benefits.
Health Care
Medical
- BMO Medical Plan SPD (BCBSIL)
- Retiree Health Reimbursement Arrangement SPD
- BMO Retiree Medical Program Eligibility and Cost Appendix
Medical Evidence of Coverage (EOC)
- Kaiser Permanente Colorado HSA Evidence of Coverage
- Kaiser Permanente Colorado DHMO Evidence of Coverage
- Kaiser Permanente S. California HSA Evidence of Coverage
- Kaiser Permanente S. California HSA Evidence of Coverage - Chiropractic and Acupuncture Amendment
- Kaiser Permanente S. California DHMO Evidence of Coverage
- Kaiser Permanente S. California DHMO Evidence of Coverage - Chiropractic and Acupuncture Amendment
- Kaiser Permanente N. California HSA Evidence of Coverage
- Kaiser Permanente N. California HSA Evidence of Coverage - Chiropractic and Acupuncture Amendment
- Kaiser Permanente N. California DHMO Evidence of Coverage
- Kaiser Permanente N. California DHMO Evidence of - Chiropractic and Acupuncture Amendment
- Kaiser Permanente Northwest HSA Evidence of Coverage
- Kaiser Permanente Northwest DHMO Evidence of Coverage
Dental
Vision
Employee Assistance Program
Tax Savings Accounts
Income Protection
Voluntary Benefits
Retirement
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
Other SPDs
2025 Summary of Benefits and Coverage (SBCs)
2024 Summary of Benefits and Coverage (SBCs)
Health Care
Prescription Drug
- 2025 Express Scripts National Preferred Formulary (includes exclusions)
- Express Scripts Exclusion List of 2025 Changes
- Kaiser Permanente Drug Formulary
(select your Region > Large Employer Group Plans (50+ Employees))
Vision
Tax Savings Accounts
Health Care
Dependent Care
Work/Life
- Family Building Benefit Request for Reimbursement
(accessible only from the BMO network) - Family Building Benefit Operating Procedure
(accessible only from the BMO network) - Sir Vincent Meredith Application Fund Form
Income Protection
Additional Forms
Medicare Special Enrollment
Health Care
- 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