Sunday, November 17, 2019

Health Care Documents


Summary Plan Description
Summary Plan Description
SUMMARY PLAN DESCRIPTION
BCBS Summary Plan Description
BCBS Summary Plan Description
SBC Medicare - May 2019
SBC PPO - May 2019
BCBS Benefits at a Glance January 2019
BCBS Benefits at a Glance January 2018
BCBS Benefits at a Glance June 2017
SBC Medicare May 2017
SBC Non-Medicare PPO May 2017
SUMMARY PLAN DESCRIPTION
SBC Medicare May 2016
SBC PPO Non Medicare May 2016
SBC Non-Medicare PPO May 2015
SBC Medicare May 2015
SBC Medicare March 2014
SBC Regular March 2014
SBC Non-Medicare PPO effective May 2013
BCBS Benefits at Glance May 2013
SBC Medicare effective May 2013
CVS Summary Plan Description
CVS Summary Plan Description
CAREMARK CVS SUMMARY PLAN DESCRIPTION
Delta Summary Plan Description
Delta Summary Plan Description
DELTA DENTAL SUMMARY PLAN DESCRIPTION
DELTA SUMMARY CHART
Summary of Material Modifications
Summary of Material Modifications
Summary of Materials Modification - May 2019
Summary of Material Modifications - January 2018
Summary of Material Modifications - June 2017
Summary of Material Modifications - January 2017
Creditable Coverage Notice
Summary of Material Modifications - November 2015
Summary of Material Modifications - March 2015
Additional Benefits May 2015
Summary of Material Modifications - September 2014
Summary of Material Modifications - March 2014
Summary of Material Modifications - January 2014
Summary of Material Modifications - November 2013
Creditable Coverage Notice - October 2013
Summary of Material Modifications - February 2013
Summary of Material Modifications - October 2012
Summary of Material Modifications - March 2012
Summary of Material Modifications - November 2018
Plan Documents
Plan Documents
OE HCP
First Amendment to the restated Health Care Plan Jan 2013
Second Amendment to the restated Health Care Plan May 2013
Third Amendment to the OE Local 324 HC Plan May 2014
Fourth Amendment to the OE 324 HC Plan Jan 2014
Fifth Amendment to the OE Local 324 Health Care Plan May 2014
Sixth Amendment to the OE Local 324 HC Plan May 14
Seventh Amendment to the Health Care Plan Oct 2014
Eighth Amendment to the Health Care Plan 2015
Ninth Amendment to the OE Local 324 Health care Plan May 2015
Tenth Amendment to the Health Care Plan Nov 15
Eleventh Amendment to the Health Care Plan
Twelfth Amendment to the Health Care Plan 2017
Thirteenth Amendment to the Health Care Plan 2018
Fourteenth Amendment to the Health Care Plan Aug 2018
OE 324 Bloomfield Medicare SBC MAY 2018
OE 324 Bloomfield PPO SBC MAY 2018
Forms
Forms
Dental Claim Form
Disability Claim Form
BCBSM Subscriber Application For Payment
Coordination of Benefits Questionnaire
HIPAA Disclosure Authorization
Instructions for Completing the HIPAA Disclosure Authorization
HIPAA Privacy Notice
MRA Requirements