Saturday, August 17, 2019

Health Care Documents


Recent Mailings
Recent Mailings
Retiree Rate Change Notice - July 2019
Glaziers Local 740 Kaiser Rate Change Notice Effective July 2019
Pre-Retirement Notification
2018 Creditable Coverage Notice
Alaska Flat Rate COBRA Rate Change Notice - Effective November 1, 2018
Alaska Hourly Rate COBRA Rate Change Notice - Effective November 1, 2018
Flat Rate COBRA Rate Change Notice - Effective November 1, 2018
Floor Covering Hourly Kaiser COBRA Rate Change Notice - Effective November 1, 2018
Glaziers Hourly Kaiser COBRA Rate Change Notice - Effective November 1, 2018
Hourly on Disability Extension COBRA Change Notice - Effective November 1, 2018
Hourly Self Funded COBRA Rate Change Notice - Effective November 1, 2018
Material Handlers COBRA Rate Change Notice - Effective November 1, 2018
Western Washington Painters COBRA Rate Change Notice - Effective November 1, 2018
OxyContin Appeal Letter
Test Strip Appeal Letter
2019 Active Summary of Benefits and Coverage
2019 Material Handler Summary of Benefits and Coverage
2019 Residential Summary of Benefits and Coverage
2019 Retiree Summary of Benefits and Coverage
2019 Kaiser Active Summary of Benefits and Coverage
Summary Annual Report - July 31, 2018
Forms
Forms
Vital Information Form
PHI Authorization for Release of Protected Health Information
Beneficiary Designation Form
Address Change Form
Temporary Total Disability Form
Enrollment Form
VSP Out of Network Reimbursement Form
Amendments and Changes
Amendments and Changes
Summary of Material Modifications - Changes to the Retiree Eligibility Provisions for Union Employees Effective August 1, 2019
Summary Of Material Modifications - Changes to Extension of Benefits During Total Disability Effective June 1, 2019
Summary of Material Modifications - Changes to the Humana Medicare Advantage Prescription Drug Plan Effective January 1, 2019
Summary of Material Modifications - New Medicare Retiree and Medicare Dependents Health Plan Effective January 1, 2019
Summary of Material Modifications - Changes to Neurodevelopmental Disorder and Speech Therapy Benefits Effective September 1, 2018
Documents / Summary Plan Description
Documents / Summary Plan Description
2018 Plan Document and Summary Plan Description
2018 Plan Document and Summary Plan Description (Spanish)