Wednesday, May 31, 2023

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
IBEW 234 Creditable Coverage Notice 2022
IBEW 234 H&W Plan Annual Notice 2022
IBEW 234 HW Plan SBC 06.2022-05.2023
IBEW 234 - SMM - Amendment 15 - $1500 Hearing Aid Allowance & TruHearing Flyer
IBEW 234 CPAP Recall Postcard
Self Pay Rate Increase Notice Active, Non-Bargaining, Early Retiree & COBRA Effective 11-01-2020
Notice of Privacy Practices for the IBEW Local 234 Health and Welfare Plan 03-2021
IBEW 234 Dignity Health Notice 2021 and Alternate Hospital List
April 2021 - Summary of Material Modification
Anthem ABA Therapy Flyer 2021
Medicare Advantage Enrollment Guide
Medicare Advantage Card-Preview
Anthem Medicare Advantage Notice of change 2021
IBEW 234 Telehealth SMM
IBEW 234 SMM - Cares Act (expanded)
Medicare House Call Program First Visit Brochure
Live Health & COVID19 info - Summary of Material Modification
Ullico Cover Letter
Anthem Live Health Flyer
Ullico Minor Letter
Ullico Letter
Summary of Benefits and Coverage (June 2019 to May 2020)
Rates and  Hour Bank Notice Effective 11-1-2018
New MediCare ID Notice
January 2018 - Summary of Material Modification
IBEW 234 Nurse Advocate Term
IBEW 234 SAR 2021 Plan Year (to Mail 2023)
Health Care Forms
Health Care Forms
Adult Dependent Enrollment Form
Authorization Agreement for Direct Payments
Authorization for Release of Protected Health Information
Coordination of Benefits Form
Enrollment Form
HMC Health Questionnaire
HRA (BennyCard) Claim Form
Life Insurance Claim Form
Medical Claim Form
Retiree Healthcare Application
Sav-RX Mail Order Form
Vision Claim Form
Health Care Plan Document/Summary Plan Description
Health Care Plan Document/Summary Plan Description
Summary Plan Description - January 2023
March 2017 HMC Newsletter
Active and Non-Bargaining Participants
Health Care Information
Health Care Information
Anthem Blue Cross - InterPlan Disclosure
Delta Dental Evidence of Coverage - June 1, 2014
Grandfathered Health Plan Notice
Inside Wage Agreement - March 24, 2014
Life Insurance Benefits - Actives
Life Insurance Benefits - Retirees
VSP Evidence of Coverage - January 2017
VSP - Eyeconic Overview
VSP - Notice of Privacy Practices
Blue Cross/Blue Shield Global Core - Brochure
Tips to Avoid Balance Billing
Medicare Advantage Plan Webinar eff. 3/1/21
Anthem Medicare Advantage Plan - LiveHealth Online
Anthem Medicare Advantage Plan - Sydney Health App
Anthem Medicare Advantage Plan - Virtual Health Programs
Anthem Medicare Advantage Plan - House Call Program
HRA Eligible Expenses  List Revised 10.2021
BeneSys NSA Notice
VSP Annual CA 2022 Member Notification
Model Disclosure Notice Regarding Patient Protections Against Surprise Billing
Health Care Amendments
Health Care Amendments
Amendment 1 - 12/20/2016
Amendment 2 - 12/20/2016
Amendment 3
Amendment 4
Amendment 5
Amendment 6
Amendment 7
Amendment 8
Amendment 9
Amendment 10
Amendment 11 (COVID)
Amendment 12
Amendment 13
Amendment 14
Amendment 15
Amendment 16
Summary Annual Reports
Summary Annual Reports
Summary Annual Report 2020
Summary Annual Report 2019
Summary Annual Report 2018
Summary Annual Report 2017
Summary Annual Report 2016
Summary Annual Report 2015
Summary Annual Report 2014
Summary Annual Report 2013
Summary Annual Report 2012
Summary Annual Report 2011
Summary Annual Report 2021
Creditable Coverage Notices
Creditable Coverage Notices
Creditable Coverage Notice 2021
Creditable Coverage Notice 2020
Creditable Coverage Notice 2019
Creditable Coverage Notice 2018
Creditable Coverage Notice 2017
Creditable Coverage Notice 2016
Creditable Coverage Notice 2015
Creditable Coverage Notice 2014
Creditable Coverage Notice 2013
Creditable Coverage Notice 2012
Creditable Coverage Notice 2011
Creditable Coverage Notice 2010