Thursday, January 29, 2026

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
Orthotics SMM
Prior Authorization on Specialty Meds - SMM
Exclusion of Gene Therapy SSM
Delta Dental Improvements
EOB-New Mailing Schedule
Medical Benefit Improvements SMM
RSV Vaccines_SMM
RSV Vaccine under 2 years of age SMM
Post Mastectomy Bra SMM
Retiree Active Coverage SMM
1095B Communication 2024
Health Care Forms
Health Care Forms
COBRA Election Form
HIPAA Disclosure Form
Spouse or Dependent Coverage
New Born Coverage
Address Verification Form
Coordination of Benefits
Prescription Reimbursement Claim Form
Health Care Amendments and Changes
Health Care Amendments and Changes
Amendment I
Amendment II
Amendment III
Amendment IV
Amendment V
Amendment VI
Amendment VII
Amendment VIII
Amendment IX
Amendment X
Amendment XI
Amendment XII
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
2014 - Plan Document
No Surprise Billing Disclosure
2022-05 - SPD OE 513 Welfare
Summary of Benefits and Coverages
Summary of Benefits and Coverages
SBC Glossary
VSP - Actives Benefit Summary
VSP - Retirees Benefit Summary
SBC Actives 2025-2026
SBC Retiree A 2025-2026
SBC Retiree B 2025-2026
Summary Annual Report
Summary Annual Report
Summary Annual Report-2024
Health Care Notices
Health Care Notices
No Surprise Medical Billing
Non-Discrimination Notice 2024
Language Services