Use these links to rapidly review the document
TABLE OF CONTENTS
SCOTT'S LIQUID GOLD
& AFFILIATED COMPANIES
EMPLOYEE BENEFIT HEALTH AND WELFARE PLAN
GROUP # 398
PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION
AMENDED AND RESTATED EFFECTIVE OCTOBER 1, 2003
IMPORTANT TELEPHONE NUMBERS
Scott's Liquid Gold-Inc.
PREFERRED PROVIDER ORGANIZATION(s) (PPOs):
Sloans Lake Managed Care (Inside Colorado)
Internet website: www.sloanslake.com
Language Other than English
(303) 691-2200 Ext. #5718
MultiPlan (Outside Colorado)
Internet website: www.multiplan.com
PRESCRIPTION DRUG PLAN:
Member Rx Services
Pharmacy Help Desk
Internet website: www.express-scripts.com
Mountain States Administration Co., Inc.
Denver Metro Area
Internet website: www.msaclaims.com
Scott's Liquid Gold-Inc. & Affiliated Companies intends for this Plan to be permanent, but since future conditions affecting
your employer cannot be anticipated or foreseen, Scott's Liquid Gold-Inc. & Affiliated Companies reserves the right to amend,
modify, or terminate the Plan at any time, which may result in the termination or modification of your coverage. Expenses
incurred prior to the Plan termination will be paid as provided under the terms of the Plan prior to its termination. Changes in the
Plan may occur in any or all parts of the Plan including, but not limited to, benefit coverage, deductibles, maximums,
coinsurance, exclusions, definitions, eligibility and the like.
The employer has initiated the Plan to provide benefits for its employees and their eligible dependents, and it shall be
maintained for this exclusive purpose.
The employer desires to provide