Saturday, July 11, 2020

Health Care Documents


Health Care Recent Mailings
Health Care Recent Mailings
HW - Covid-19 Mailing
Health Care Forms
Health Care Forms
ACH Form (Retiree - Selfpay)
Address Change Form
Beneficiary Designation Form – Health
Death Beneifits Application
Cigna Claim Form
Express Scripts Claim Form
Life Insurance Affidavit (Template)
New Member Packet - New Hire
PCA Reimbursement Form
Retiree Application Packet
Temporary Total Disability
Enrollment Form - Active Regular
Enrollment Form - Active Basic
Enrollment Form - Active Non-Bargaining
2020 COBRA Rates
Health Care Amendments and Changes
Health Care Amendments and Changes
Basic Plan SPD Amendment 1
Basic Plan SPD Amendment 2
Basic Plan SPD Amendment 3
SPD Health Amendment 1
SPD Health Amendment 2
SPD Health Amendment 3
SPD Health Amendment 4
SPD Health Amendment 5
SPD Health Amendment 6
SPD Health Amendment 7
SPD Health Amendment 8
SPD Health Amendment 9
SPD Health Amendment 10
SPD Health Amendment 11
SPD Health Amendment 12
SPD Health Amendment 13
SPD Health Amendment 14
SPD Health Amendment 15
SPD Health Amendment 16
SPD Health Amendment 17
SPD Health Amendment 18
SPD Health Amendment 19
SPD Health Amendment 20
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Basic Plan Summary Plan Description 3-1-2018
Benefit Fund Summary Plan Description 1-1-2014
Doctor On Demand Flyer
Dr. On Demand 8th Dst. Member Registration Guide
2020 Basic Plan SBC - effective 1-1-20 to 12-31-20
2020 Regular Plan SBC - effective 1-1-20 to 12-31-20