Monday, November 30, 2020

H&W/VEBA Documents


Health Care & VEBA Documents / Summary Plan Description
Health Care & VEBA Documents / Summary Plan Description
H&W Summary Plan Description 2009
VEBA Summary Plan Description August 2013 Edition
2015-2016 Kaiser Summary of Benefits and Coverage (SBC)-Actives
Health Care & VEBA Amendments and Changes
Health Care & VEBA Amendments and Changes
H&W Amendment #1
H&W Amendment #2
H&W Amendment #3
Wage Works Change Notice
SMM Hour Bank Change & Saftey Glasses
Health Care & VEBA Participant Notifications
Health Care & VEBA Participant Notifications
Required Notice Of Health Insurance Exchange Coverage Options September 2013
July 2013  H&W SMM-Notice of Loss of Grandfather Status
Janaury 2013 H&W  SMM Domestic Partnership
Retiree Self Pay Rate Increase Effective 11-1-13
Reciprocity Eligibility Procedures May 2013
June 2013 H&W SMM - Kaiser Benefit Changes
Non Bargaining Self Pay Rate Increase Effective 11-1-13
VEBA Summary Annual Report Plan Year Ending 1-31-13
VEBA Summary Annual Report Plan Year Ending 1-31-14
December 2012 H&W SMM - Health Care Reform
July 2012 VEBA SMM-Change in Eligibility for SAS Account Withdrawals
VEBA Summary Annual Report Plan Year Ending 1/31/2012
VEBA Summary Annual Report For Plan Year End 1-31-11
COBRA Rate Increase Effective 11-1-13
2014 Annual Notice of Credible Coverage
2014 Annual Womens Notice of Cancer Rights & Newborns & Mothers Protection Act Notice
Active Self Pay Rate Increase Effective 11-1-13
2013 Kaiser Plan Change - Cover Letter, Q&A, and Benefit Summary
Health and Welfare Summary Annual Report For Plan Year End 1-31-11
Heath & Welfare Summary Annual Report for Plan Year Ending 1/31/2012
Health & Welfare Summary Annual Report Plan Year Ending 1-31-13
Health & Welfare Summary Annual Report Year ending 01-31-2009
Heath & Welfare Summary Annual Report for Plan Year Ending 1/31/2014
December 2015 SMM H&W-Buy Up Provision
November 2015 SAR H&W
December 2015 H&W - Kaiser Pay to Provider Program
August 2015 H&W - Eligibility Procedures for Reciprocity Work Hours
May 2015 H&W - Summary of Benefits & Coverage Cover Letter
October 2015 H&W - Active Self-Payment Rate 12/1/2015
October 2015 H&W - Retiree Self Pay Rate Increase 12/1/2015
November 2015 VEBA SAR
October 2015 H&W - Womens Health Newborn Act Annual Notification
February 2016 H&W SMM-UHC Dental 4/1/2016
February 2016 H&W SMM-Retiree UHC Dental & Rate Change 4/1/2016
Kaiser Deductible & Coinsurance Reimbursement for 2016 Claims Deadline
2018 Benefits Fair Notice
H&W SAR 1-31-2017
Health Care & VEBA Forms
Health Care & VEBA Forms
Request for Waiver of Kaiser Coverage
Other Insurance Inquiry Form
Kaiser Enrollment Form
Vital Enrollment Form
VEBA & Deductible & Coinsurance Reimbursement Medical Account Claim Form
Retiree Health Care Application
Kaiser Benefit Summary - Medicare Retirees Effective 6-1-14 thru 5-31-15
Authorization to Release PHI
Address Verification Change Form
Kaiser Benefit Summary - Actives & Non Medicare Retirees Effective 6-1-14 thru 5-31-15
Instructions For PHI Authorization Form
HIPAA Privacy Notice
Kaiser Information
Kaiser Information
Kaiser National Emergency Care Brochure