Monday, March 2, 2026

Health Care Documents

Recent Mailings
Recent Mailings
IBEW 234 Summary Annual Report 2022 Plan Year (to Mail 2024)
IBEW 234 HW Plan SBC June 2024-2025
IBEW 234 Self Pay Rates Notice Eff. 11-1-2024
IBEW 234 Health Creditable Coverage Notice 2024
IBEW 234 HW Plan Annual Notice 2024
IBEW 234 Non-discrimination-Section 1557 Notice
IBEW 234 Notice of Availability of Language Services and Auxiliary Aids and Services
IBEW 234 Retiree Rate Increase Notice eff April 2025
IBEW 234 SMM - ADHD Coverage
IBEW 234 Notice to Actives re $0.15 HRA Reallocation & Retiree SP Increase
IBEW 234 Health and Welfare Plan HRA Balance Transfer Policy and Form
IBEW 234 Summary Annual Report 2024 Plan Year
IBEW 234 HW Plan SBC June 2025-2026
IBEW 234 HW Plan Annual Notice 2025
IBEW 234 Health Creditable Coverage Notice 2025
IBEW 234 Self Pay Rates Notice Eff. 11-1-2025
IBEW Local 234 - Retiree First Announcement Letter & FAQ
Community Hospital of the Monterey Peninsula Hospital (CHOMP) – Contract Negotiations
Retiree and Surviving Spouse Health Care Rates – Effective April 1, 2026
IBEW Local 234 - Retiree First Announcement Letter
Forms
Forms
Authorization Agreement for Direct Payments
Authorization for Release of Protected Health Information
Coordination of Benefits Form
Enrollment Form
HRA (BennyCard) Claim Form
Retiree Healthcare Application
Summary Plan Description & Amendments
Summary Plan Description & Amendments
Summary Plan Description - January 2023
Information
Information
Delta Dental Benefits Summary
Grandfathered Health Plan Notice
HRA Eligible Expenses  List Revised 10.2021
No Surprise Act Notice 2022
VSP Benefit Summary (eff. 1-1-2026)