Tuesday, February 3, 2026

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
2022 Summary Annual Report
2022 Triennial Privacy Practices Notice
2022 Creditable Coverage Notice
2022 Women's Cancer Notice
2023 Flu Vaccine Notice
2023 Summary Annual Report
2023 Women's Cancer Rights Notice
2023 Creditable Coverage Notice
Health Care Forms
Health Care Forms
Enrollment Form
PHI Form
Life Insurance Beneficiary Form
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Local 992 Welfare SPD - 2019
Health Care Amendments and Changes
Health Care Amendments and Changes
Summary of Material Modification #1 and COVID-19 Letter
Summary of Material Modification #2
Summary of Material Modification #3
Summary of Material Modification #4
Summary of Material Modification #5 - No Surprises
Summary of Material Modification #6 - Benefit Clarifications
Summary of Material Modification #7 - End of COVID and GLP-1 Drugs
Summary of Material Modification #8 - Vision Provider and Lipiflow Coverage
Summary of Material Modification #9 - Coinsurance and Deductibles
Summary of Material Modification #10 - Removal of Dental Pre-Approval
Summary of Material Modification #11 - Increase Orthodontia and Accident & Sickness Benefits and coverage for Wegovy and Genetic Testing
Summary of Material Modification #12
Summary of Material Modification #13
Summary of Benefits and Coverages
Summary of Benefits and Coverages
2023 Hagerstown SBC
2024 Hagerstown SBC
REVISED 2024 Hagerstown SBC
2025 Hagerstown SBC