Wednesday, September 18, 2019

Health Care Documents


Health Care Amendments and Summary of Material Modifications
Health Care Amendments and Summary of Material Modifications
SMM CHECK STUB ELIGIBILITY EFFECTIVE 1-1-2018
SMM DIABETIC SUPPLIES COVERAGE FOR MEDICARE RETIREES EFFECTIVE 1-1-2018
SMM 100 HOURS PER MONTH ELIGIBILITY REQUIREMENT EFFECTIVE 6-1-2017 WORK, 8-1-2017 ELIGIBILITY
SMM ST. ROSE/DIGNITY HEALTH INCLUDED IN THE PPO NETWORK EFFECTIVE 1-1-2016
SMM OUT OF POCKET MAX FOR EMERGENCY SERVICES EFFECTIVE 1-1-2016
SMM DELTA DENTAL REPLACING LIBERTY DENTAL (HMO) EFFECTIVE 10-1-2015
SMM PREVENTIVE CARE EFFECTIVE 7-1-2015
SMM DENTAL IMPLANT COVERAGE EFFECTIVE 1-29-2015
SMM  2015 ANNUAL OUT-OF-POCKET MAXIMUM, EFFECTIVE 1-1-2015
SMM CHANGES TO YOUR LIBERTY DENTAL PLAN BENEFITS
SMM HIPAA UPDATES EFFE 9-23-13
SUMMARY OF MATERIAL MODIFICATION ICM EFF 12-1-2011
HUMANA GROUP MEDICARE ADVANTAGE PLAN EFF. 1-1-2019
BANK HOUR MAXIMUM CHANGE EFF 1-1-2019
H&W SMM Amendment No. 13 – Disability Claim Procedures – Effective 4/1/18
H&W SMM Amendment No. 14 – Hearing Aid Benefit – Retiree Coverage – Effective 1/1/19
H&W SMM Amendment No. 15 - Weekly Disability Increase - Effective 5/1/19
V100 - SMM HW - Return to Covered Employment
Health Care Forms
Health Care Forms
DELTA DENTAL ENROLLMENT FORM EFFECTIVE 10-1-2015
AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFO
DEPENDENT COVERAGE REQUIREMENTS
DISABILITY APPLICATION FORM
ENROLLMENT FORM
BENEFICIARY FORM
OTHER INSURANCE FORM
Health Care Mailings
Health Care Mailings
CARE ASSIST PROGRAM (CAP) EFF 3-1-2013
H&W IRS DETERMINATION LETTER 6-30-85
HEALTHCARE INSURANCE EXCHANGE PARTICIPANT NOTICE EFF 9-1-13
HOSPITALIST SERVICES EFF 5-1-11
ICM PROGRAM OVERVIEW
MEDICARE PART D NOTICE - NOV 2010
TRANSITION CARE PROGRAM (TCP) EFF 3-1-2013
VSP NETWORK CHANGE NOTICE - EFF 7-1-11
STATE OF THE UNION - 2008
STATE OF THE UNION - 2009
STATE OF THE UNION - 2010
STATE OF THE UNION - 2011
STATE OF THE UNION - 2012
STATE OF THE UNION - 2013
STATE OF THE UNION - 2017
Humana PDP Medicare Prescription Plan Announcement Eff 1-1-2016
HEALTH PLAN OF NEVADA (HMO MEDICAL PLAN) TERMINATION EFF 1-1-2016
HCA REMAINS IN NETWORK NOTICE EFF 3-1-2016
NOTICE OF NONDISCRIMINATION
COBRA RATES EFF. 1-1-2017
VALLEY HEALTH SYSTEM HOSPITALS IN NETWORK EFF. 1-1-2017
WOMEN'S HEALTH & CANCER RIGHTS AND NEWBORNS' AND MOTHERS' HEALTH PROTECTION ACT NOTICE 2017
CREDITABLE COVERAGE NOTICE - OCTOBER 2018
HUMANA GROUP MEDICARE ADVANTAGE PLAN EFF. 1-1-2019
NOTICE OF NON VESTED BENEFITS 10-4-18
BANK HOUR MAXIMUM CHANGE EFF. 1-1-2019
COBRA Rates, eff 1-1-19
Notice of Rx Gag Clause Changes 12-17-18
HUMANA MEDICARE PLAN - MEMBER NOTICE ABOUT PROVIDERS 03-27-19
HUMANA MEDICARE PLAN - PROVIDER FLYER 03-27-19
H&W SMM Amendment No. 13 – Disability Claim Procedures – Effective 4/1/18
H&W SMM Amendment No. 14 – Hearing Aid Benefit – Retiree Coverage – Effective 1/1/19
SUMMARY ANNUAL REPORT - HEALTH & WELFARE
SMM HW Amendment No. 15 - Weekly Disability Increase - Eff 05-01-19
V100 - SMM HW - Return to Covered Employment - Medicare Retirees
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
H&W SUMMARY PLAN DESCRIPTION EFF 7-1-2014
SBC Eff 1-1-19 - 12-31-19