Rose City Liquor, Inc.

Rose City Liquor
Employee Benefit Programs
Documents, Forms, and Resources
January 1, 2026 to December 31, 2026

Kaiser Medical
Silver 3000 w/VX and Massage Benefit Summary
Silver 3000 w/VX and Massage Summary of Benefits and Coverage (SBC)
Enrollment/Change Form
Waiver Form
Convenient ways to get care
Pharmacy Resources
About Kaiser

Kaiser Dental
Traditional 100 – $1500 with Ortho Benefit Summary
Find Dentists and Locations
About Kaiser Dental

125b Cafeteria Plan
Summary Plan Description
Election Form
Change and Revocation Form
Pre-Tax Savings Calculator

Notices
ACA Exchange Model Notice
Medicare Creditable Pharmacy Disclosure
ERISA Wrap Document

Eligibility and Contributions
Employees must work 35 hours per week on a regularly scheduled basis
Coverage begins first of the month following 30 days of employment
Open enrollment is December 1st through December 31st for a January 1st start date annually 
Employer pays 50% for employee only on the Kaiser Medical Plan, and 0% for Dependents
Employer pays 50% for employee only on the Kaiser Dental Plan, and 0% for Dependents
Employer pays 0% for Pediatric Preventive Dental

Account Manager and Support Staff Contact Information
Contact Paris Laughlin – Agent
Contact Rachel Laughlin – Account Manager
Contact Sarah Selix – Assistant