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I.B.E.W Local 234
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Recent Mailings
Recent Mailings
IBEW 234 Creditable Coverage Notice 2022
IBEW 234 H&W Plan Annual Notice 2022
Notice of Privacy Practices for the IBEW Local 234 Health and Welfare Plan 03-2021
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
Anthem Live Health Flyer
IBEW 234 SAR 2021 Plan Year (to Mail 2023)
IBEW 234 Self Pay Rates Notice Eff. 11-1-2023
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
Sav-RX Mail Order Form
VSP Member Reimbursement Form
Summary Plan Description & Amendments
Summary Plan Description & Amendments
Summary Plan Description - January 2023
Summary of Benefits and Coverage
Summary of Benefits and Coverage
Summary of Benefits and Coverage (SBC) June 2023-24
Information
Information
Delta Dental Benefits Summary
Delta Dental Evidence of Coverage (EOC)
Grandfathered Health Plan Notice
Blue Cross/Blue Shield Global Core - Brochure
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
No Surprise Act Notice 2022
VSP Benefit Summary