Wednesday, September 18, 2019

Health Care Documents


Health Care Recent Mailings
Health Care Recent Mailings
2019 Open Enrollment Notice
Smmary of Material Modifications (SMM) 11.1.2018
2019 IBU Trust PPO SBC
IBU Health PPO Annual Notices 2018
IBU Health HRA Annual Notices 2018
HMC Letter to Participants, CA 8.2018
HMC Letter to Participants 8.2018
Summary Annual Report IBU Health 2017
Summary Annual Report IBU Health HRA 2017
IBU HRA 2019 Annual Notice
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Uniform Glossary of Health Coverage and Medical Terms
Moda Vaccine Flyer
Notice of Nondiscrimination
Privacy Notice
Summary of Benefits and Coverage 2018 – HMSA Plan - Actives and Retirees
Summary of Benefits and Coverage 2018 – Kaiser Plan Hawaii - Actives
Summary of Benefits and Coverage 2018 – Kaiser Plan Northern California - Actives
Summary of Benefits and Coverage 2018 – Kaiser Plan Oregon - Actives
Summary of Benefits and Coverage 2018 – Kaiser Plan Oregon - Retirees
IBU NHBT PPO Plan SPD 6.1.19
Retiree HRA Plan Document 2016
HRA SMM November 2016
Health Care Forms
Health Care Forms
Privacy-Authorization Form for Release of PHI
Privacy-Request for Restrictions on Use or Disclosure of PHI
Trust Plan Enrollment 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
Beneficiary Form
Timeloss and Disability Waiver Form
Health Care Amendments and Changes
Health Care Amendments and Changes
No documents available.
Summary of Benefits and Coverages
Summary of Benefits and Coverages
2019 IBU Trust PPO SBC
2019 Kaiser N.CA SBC
2019 HMSA SBC
2019 Kaiser Hawaii SBC
2019 Kaiser NW (OR) SBC