Inlandboatmen's Union of the Pacific National Benefit Benefit Funds

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Health Care Documents

Health Care Recent Mailings

	2026 Open Enrollment

	2026 HRA Funding

	Premera 365 Flyer

	Oct 2024 SMM

	VSP Summary

	Kaiser Denver/Boulder Care Options Member Flier

	No Surprise Act Notice

	No Surprises Act Notice Spanish

Announcements

	IBU Teladoc Benefit Announcement 6.1.2020

	Kaiser Mental Health-Resources 6.2020

	Kaiser Mindfulness and Self-Care Resources_4.28.2020

	Kaiser Calm App for Self Care

Health Care Documents / Summary Plan Description

	Moda Vaccine Flyer

	Uniform Glossary of Health Coverage and Medical Terms

	Privacy Notice

	IBU NHBT PPO Plan Benefit Book - SPD 1.1.2024

	IBU NHBT PPO Plan Benefit Book - SPD Cover Letter 1.1.2024

	IBU Rx Plan FAQ

Health Care Forms

	Trust Plan Enrollment Form

	Privacy-Authorization Form for Release of PHI

	Beneficiary Form

	HMSA Enrollment form 2019

	Medical Plan Claim Form

	Dental Plan Claim Form

	Vision Claim Form

	Rx Postal Prescripion Services

	RX Claim Form for a Compounded Prescription

	RX Claim Form

	Supplemental Claim Form

	Transportation and Alternative Housing Claim Form

	Domestic Partner Autopay Form

	Domestic Partner Affidavit

	Timeloss and Disability Waiver Form

	HMSA Hawaii Enrollment Form

	Kaiser Hawaii Enrollment Form

	Kaiser N. CA Enrollment Form

	OTC COVID Test Claim Form

Summary of Benefits and Coverages

Plan Fillings and Documents

	Health- 5500 for the plan year ending December 31, 2018

	HRA- 5500 for the plan year ending December 31, 2018

	IBU Health 5500 2019

	IBU HRA 5500 2019