Tuesday, May 11, 2021

Health Care Documents


Health Care Amendments and Summary of Material Modifications
Health Care Amendments and Summary of Material Modifications
No Documents available
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
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
VALLEY HEALTH SYSTEM HOSPITALS IN NETWORK EFF. 1-1-2017
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
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
SMM HW - Return to Covered Employment - Medicare Retirees
CREDITABLE COVERAGE NOTICE - OCTOBER 2019
WOMEN'S HEALTH & CANCER RIGHTS AND NEWBORNS' AND MOTHERS' HEALTH PROTECTION ACT NOTICE - OCTOBER 2019
SUMMARY ANNUAL REPORT- HEALTH & WELFARE
Notice of COBRA Extension - COVID-19 Update
COBRA Rates Eff. 1-1-21
IRS 1095-B Form Notice
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
H&W SUMMARY PLAN DESCRIPTION EFF. 01-01-2020
SBC Effective 1-1-21 to 12-31-21
SMM - H&W AMENDMENT NO. 1