Legal Notices, Plan Documents and Forms

Legal Notices

Safe Harbor Plan Notice Alkali 2023 (updated October 2023)

Safe Harbor Plan Notice Energy 2023 (updated October 2023)

2022 404a Fee Disclosure Genesis Alkali Investment Savings Plan (updated April 2022)

2022 404a Fee Disclosure Genesis Energy Retirement Savings Plan  (updated April 2022)

2022 404(a) Fee Disclosure for Genesis Marine 1165E Plan (updated September 2022)

Medicare Part D Notice of Credible Coverage for Rx (updated October 2023)

Notice of Health Insurance Marketplace Coverage (updated October 2023)

HIPAA Notice Privacy Practices (updated November 2022)

HIPAA Notice of Special Enrollment (updated November 2022)

Newborns’ and Mothers’ Health Protection Notice  (updated November 2022)

Women’s Health and Cancer Rights (updated November 2022)

Notice of COBRA Continuation Coverage Rights (updated November 2022)

Children Health Insurance Program (CHIP) Notice (updated November 2023)

2022 Summary Annual Report – Genesis Energy 401(k) (Updated December 2023)

2022 Summary Annual Report – Alkali 401(k) (Updated December 2023)

2022 Summary Annual Report – Non-Union Health and Welfare Plan (Updated December 2023)

 

 

Plan Documents and Summary Plan Descriptions (SPDs)

2024 Medical Plan Booklet – PPO Plan

2024 Medical Plan Booklet – HDHP

2024 Summary of Benefits Coverage – HDHP

2024 Summary of Benefits Coverage – PPO Plan

Dental Summary Plan Description

Genesis Energy Health and Welfare Benefits Plan Summary Plan Description

Life, AD&D, Optional Group Life and AD&D, Dependent Group Life Certificate (Genesis Energy Employees excluding Drivers)

Life, AD&D, Optional Group Life and AD&D, Dependent Group Life Certificate (Genesis Energy Drivers)

Short-term Disability Certificate (Genesis Energy Employees excluding Mariners)

Short-term Disability Certificate (Genesis Marine Mariners)

Long-term Disability Certificate (Genesis Energy Employees excluding Drivers)

Long-term Disability Certificate (Genesis Energy Drivers)

TRIPLE-S Pharmacy Coverage

TRIPLE-S Group Health Plan Rider

TRIPLE-S Major Medical Expense Rider

TRIPLE-S Summary of Benefits and Coverage Genesis Mar LLC English 09-01-2021 through 08-31-2022

TRIPLE-S Summary of Benefits and Coverage Genesis Mar LLC Spanish 09-01-2021 through 08-31-2022

TRIPLE-S Summary Plan Description

To access the SPD for the 401(k) Plan, you must login to your Fidelity account here. Once you’ve logged in, go to Menu > Learn > “Forms and Plan Information” >  Plan Information and Documents

 

Forms/Guidelines

Fidelity QDRO – Guidelines

Benefits Dependent Verification Document Requirements

BenefitHub Employee Discount Program

 

PRINTED PLAN DOCUMENTS AND LEGAL NOTICES AVAILABLE

We have posted the SPDs, SBCs and Legal Notices online to help ensure you have easy access to your benefits information. If you prefer to receive a printed copy of the SPDs, SBCs or any legal notices, we will provide one to you at no charge. Contact the BenefitsConnections team at (877) 241-9624 or [email protected] to request a printed copy.

Employees whose benefit plan participation is governed by a collective bargaining unit must refer to the collective bargaining agreement to identify the benefit plans in which the collective bargaining unit participates. The benefits on this site do not apply to collective bargaining units.

*This site highlights your benefits. Official plan and insurance documents govern your rights and benefits under each plan. For more details about your benefits, including covered expenses, exclusions, and limitations, please refer to the individual summary plan description (SPD), plan document, or certificate of coverage for each plan. If any discrepancy exists between information on this site and the official plan contracts, the official plan contracts will prevail.