Wednesday, April 21, 2021

Health Care Documents


Health Care Recent Mailings
Health Care Recent Mailings
Medicare Advantage Enrollment Guide
Medicare Advantage Card-Preview
Anthem Medicare Advantage Notice of change 2021
IBEW 234 Annual Notice 2020
IBEW 234 Telehealth SMM
IBEW 234 SMM - Cares Act (expanded)
Summary of Benefits and Coverage (June 2020 to May 2021)
Live Health & COVID19 info - Summary of Material Modification
Anthem Live Health Flyer
Ullico Cover Letter
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
HRA Benny Card Plan Information
Wellness Program Reminder
Mar 2015 - Blue Cross Cyber-Attack Memo
Wellness Program Notice
Dec 2014 - VSP Announcement Effective 01-01-15
Jun 2014 - Active, Non-Bargaining & COBRA Rates Effective 9/1/2014
Sep 2013 - Employer Exchange Notice
Jun 2014 - Retiree Rate Increase Notice Effective 9/1/2014
Jan 2014 - Summary of Material Modifications
Apr 2013 - Chip Notice
Mar 2013 - Supplemental Dental, Vision & Rx Card Letter
Feb 2013 - Blue Cross ID Card Letter to Medicare Supp
Feb 2013 - Transition to Blue Cross March 1, 2013 and 24 Hour Nurseline
Sep 2013 - Notice of Privacy Practices
Jul 2012 - SMM Eliminating Erectile Dysfunction Medication
Jun 2012 - Annual Maximum Benefit Notice
Feb 2012 - SMM Preventive Care Services
Self Pay Rate Increase Notice Active, Non-Bargaining, Early Retiree & COBRA Effective 11-01-2020
Women's Health Annual Notice 03-2021
Notice of Privacy Practices for the IBEW Local 234 Health and Welfare Plan 03-2021
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 2016
Newsletters
Newsletters
March 2017 HMC Newsletter
Active and Non-Bargaining Participants
Health Care Information
Health Care Information
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
Blue Cross/Blue Shield Global Core - Brochure
Tips to Avoid Balance Billing
Medicare Advantage Plan Webinar eff. 3/1/21
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
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
Creditable Coverage Notices
Creditable Coverage Notices
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