Wednesday, December 4, 2024

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
Self-pay Option and Dental Benefit
Summary Annual Report - HW
SMM - End of COVID-19 Extension
Short Pay and Ground Ambulance
Retiree Self-Pay Rates 2024
Notice of Non-Discrimination
NCTI HW SAR 2023
Medicare Part D Creditable Coverage Notice
SMM: Amdt 8 - Short Hour Extension
Health Care Forms
Health Care Forms
Reciprocity Authorization Form.Home
Reciprocity Authorization Form.Traveler
COBRA Extended ARPA
Address Verification Form
Authorization for Self-Payment Deduction
Disability Physician Statement Form
Enrollment Form - Actives
Vital Information Form
Disabled Dependent Information
Beneficiary Form
New Member Packet
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Health & Welfare SPD 2023
1st Amendment
2nd Amendment
3rd Amendment
4th Amendment
5th Amendment
Newsletters
Newsletters
Sav-Rx Mobile App Flyer
Summary of Benefits and Coverages
Summary of Benefits and Coverages
Kaiser SBC 3/1/2024 to 2/28/2025
PPO SBC 7/1/2024 to 6/30/2025