Wednesday, March 19, 2025

Health Care Documents

New Member Packet
New Member Packet
New Member Packet
Health Care Recent Mailings
Health Care Recent Mailings
7377 CMRCC Employer Notice Self Mailer
CMRCC Welfare Merger January 1, 2025 SMM
IKORCC HW - SMM Mailing 11.30.23
IKORCC HW - SMM Mailing
BeneSys NSA Notice12-21-2021
SMART_CMRCC_Active
IKORCC Mobile App
IKORCC HW- SPD Mailing 1.22.24
(SMM) Clarification - Weight Loss
Notice of Nondiscrimination
(SMM) IKORCC 9th Amendment
IKORCC GLP-1 SMM
A700 IKORCC Health SMM - 10th Amendment & Mother and Newborns Self Mailer
2025 Active CMRCC SBC
2025 Med Advantage CMRCC SBC
Health Care Forms
Health Care Forms
Reciprocity Form
Vital Information Form/Update Beneficiary
Member Authorization Release of Protected Health
Medical Reimbursement (MRA) Claim Form
Reimbursement Card Transaction Dispute Form
Plan Document and Amendments
Plan Document and Amendments
IKORCC 2022 Update Welfare Plan Restatement
IKORCC HW 1st Amendment
IKORCC HW 2nd Amendment
IKORCC HW 3rd Amendment
IKORCC HW 4th Amendment
IKORCC HW 5th Amendment
IKORCC HW 6th Amendment
IKORCC HW 7th Amendment
IKORCC HW 8th Amendment
IKORCC HW 9th Amendment
Summary Plan Description/ Summary of Material Modifications
Summary Plan Description/ Summary of Material Modifications
(SMM) CMRCC Welfare Merger January 1, 2025
(SMM) Out-of-Network Medical Benefit Claim
(SMM) Clarification Weight Loss Drugs and Gene Therapy Exclusion
(SMM) Hearing Aids and Premium-Banking Threshold
(SMM) TruHearing Clarification Hearing Aids
IKORCC Health - Summary Plan Description - 2024
A700 IKORCC Health SMM - 10th Amendment & Mother and Newborns Self Mailer
Summary of Benefits and Coverages
Summary of Benefits and Coverages
2016 SBC
2017 SBC
2018 SBC
2019 SBC
2021 SBC
2022 SBC
2023 SBC
2024 SBC
Services that Require Precertification (4.1.24)
Annual Reports
Annual Reports
2016 SAR
2017 SAR
2018 SAR
2019 SAR
2020 SAR
Notice of Creditable Coverage
Notice of Creditable Coverage
2022 Notice of Creditable Coverage
2023 Notice of Creditable Coverage
Dental / Vision / Teladoc / The Clinic / Tru Hearing
Dental / Vision / Teladoc / The Clinic / Tru Hearing
Cleveland Clinic Virtual Second Option
Teladoc General Care
Teladoc Dermatology Care
Teladoc Behavioral Mental Health Care
Delta Dental SBC 2024
Tru Hearing