Wednesday, October 14, 2026

Health Care Documents

Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Summary Plan Description and Plan Document-January 1, 2018
2025 VSP Benefits
2026 Kaiser Plan SBC
2026 Kaiser Everyday Plan SBC
2026 Comprehensive Health Plan SBC
2026 CDHP SBC
2026 Premium Plan SBC
Summary of Benefits and Rates
Summary of Benefits and Rates
SBC Uniform Glossary
2025 VSP Summary of Benefits
2026 Local 125 COBRA Rates
2026 Local 57 COBRA Rates
2026 Local 77 COBRA Rates
2027 Local 125 Rates
2027 Local 57 Rates
2027 Local 77 Rates
Health Care Forms
Health Care Forms
Medical/Vision Reimbursement Claim Form
LHCFSA Claim Form
FSA Claim Form
COBRA 125 Rate Enrollment Form
COBRA 57 Rate Enrollment Forms
COBRA 77 Rate Enrollment Form
Health Care Recent Mailings
Health Care Recent Mailings
Marketplace Exchange Notice 04-05-2024
Trust Fund Privacy Practice(s)
CareAllies Health Risk Assesment Instructions
2026 Creditable Coverage Notice
2027 Local 57 Open Enrollment Guide
2027 Local 77 Open Enrollment Guide
2027 Local 125 Open Enrollment Guide
2027 Open Enrollment Postcard
Health Care Amendments and Changes
Health Care Amendments and Changes
No Surprises Act - Notice 1/1/2022
Machine Readable File Out of Network
Machine Readable File Out of Network
Out of Network - MRF