Compliance & Reference

Legal Notices

This section includes key details about your benefit plans along with legally required notices and helpful reference materials. You can view or download any document by clicking the links below. If you'd like a printed version, contact the HR Services Support Center to request a copy by calling 888-659-3616 or emailing EnsignHR@ensignservices.net.

Plan Notices & Guides

View or download plan disclosures and SPDs

Tax Form 1095 Notices

Notice of availability and request options

Documents & Disclosures

Required Disclosures & Plan Guides

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Showing 24 Documents

Legal Notices

2026 Open Enrollment Legal Notices

Annual disclosures, rights, and responsibilities concerning the Ensign benefits program.

PDF • 820 KB

Legal Notices

Health and Welfare

Comprehensive Summary Plan Description for the health and welfare benefit plans.

PDF • 1.4 MB

Legal Notices

Ensign Facility Reopening Amendment

Amendment details regarding facility reopening and safety accommodations.

PDF • 140 KB

Medical

Ensign SAR 2027

Summary Annual Report (SAR) disclosure for the Ensign health and welfare benefit plan.

PDF • 40 KB

Medical

HealthEquity Flexible Benefits Plan SPD

Summary Plan Description for the flexible spending and health equity benefits.

PDF • 450 KB

Medical

Garner SPD Value Copay Plan

Garner health reimbursement arrangement details for the Value Copay plan.

PDF • 650 KB

Medical

Garner SPD Value Copay (EPO BlueHPN)

Garner HRA details for the EPO BlueHPN Value Copay plan.

PDF • 670 KB

Medical

Garner SPD Premier EPO UT 2026

Garner HRA Summary Plan Description for the Utah Premier EPO plan (2026).

PDF • 580 KB

Medical

Garner SPD Premier EPO 2026

Garner HRA Summary Plan Description for the Premier EPO plan (2026).

PDF • 580 KB

Medical

Garner SPD Choice HSA PPO UT 2026

Garner HRA Summary Plan Description for the Utah Choice HSA PPO plan (2026).

PDF • 590 KB

Medical

Garner SPD Choice HSA PPO 2026

Garner HRA Summary Plan Description for the Choice HSA PPO plan (2026).

PDF • 590 KB

Medical

Garner SPD Value Copay Plan UT

Garner HRA Summary Plan Description for the Utah Value Copay plan (2026).

PDF • 640 KB

Medical

Kaiser NorCal Deductible HMO EOC

Evidence of Coverage for the Northern California Kaiser Deductible HMO plan.

PDF • 2.1 MB

Medical

Centivo SPD

Summary Plan Description for the Centivo PCP Partnership medical plan.

PDF • 1.9 MB

Dental

Cigna DHMO SPD

Summary Plan Description for the Cigna Dental HMO plan.

PDF • 850 KB

Dental

Cigna Dental Rider (AR, IN, LA, MN, NV...)

Cigna Dental state-specific coverage rider details.

PDF • 240 KB

Dental

Cigna Dental PPO Outside-CA SPD

Summary Plan Description for Cigna Dental PPO members outside California.

PDF • 940 KB

Dental

Cigna Dental CA PPO SPD

Summary Plan Description for Cigna Dental PPO members in California.

PDF • 910 KB

Vision

VSP Vision EOC

Evidence of Coverage for the Vision Service Plan (VSP).

PDF • 310 KB

Voluntary Medical Benefits

Hospital Indemnity Certificate of Coverage

Certificate of Coverage for the voluntary hospital indemnity insurance.

PDF • 680 KB

Voluntary Medical Benefits

Critical Illness Certificate of Coverage

Certificate of Coverage for the voluntary critical illness insurance.

PDF • 790 KB

Voluntary Medical Benefits

Accident Certificate of Coverage

Certificate of Coverage for the voluntary accident insurance.

PDF • 720 KB

401K

Ensign 401k SPD

Summary Plan Description for the Ensign 401(k) Retirement Savings Plan.

PDF • 1.6 MB

Leave of Absence(LOA)

Leave of Absence Index

Quick reference index for leave of absence guidelines and processes.

PDF • 210 KB

Document Preview

Select any document notice from the list on the left to preview it directly on this page.

Form 1095 Availability

Important Health Coverage Tax Documents

Notice of Availability of Tax Form 1095

In accordance with the Paperwork Burden Reduction Act, effective for forms for Tax Year 2025, Your Employer will no longer be furnishing IRS Form 1095 automatically to all active employees unless required by state law. Instead, forms will be provided upon request.

Benefits Portal

If you want to obtain your Form 1095, you may do so by logging into your benefits portal at https://app.unifyhr.com/ and selecting the option to submit a request for a copy of your form.

Written Request

You may alternatively request your form by writing to WEX ACA 1095, P.O. Box 2310, Fargo, ND 58108-2310. To request your 1095 form in writing, please complete this 1095 Form Request Template and mail it to the PO Box provided in this notice.

Email Request

Employees can also email benefits@ensignservices.net with the Subject: NAME ID# 1095-C Request and the HR Support team will provide a digital copy when available.

Support Assistance

If you have questions or need assistance logging into your portal or requesting your form, please call the HR Service Support Center at 888-659-3616 (Weekdays, 8 AM - 5 PM PT) or email ACA1095Request@wexinc.com. Forms will be available within 7-10 business days after a request is received.

Tax Notice Details

Availability Info

Applicability

Employees living in a state where state law requires forms to be furnished will continue to receive a form automatically, and forms will be sent in accordance with the applicable state's requirements.

Important Contacts

888-659-3616 ACA1095Request@wexinc.com

Tax Document Reference Guides

1095 Poster

1095 Form Request UHR

WEX ACA Participant Portal Guide – PBRA