Wednesday, May 12, 2021

Health Care Documents


Health Care Amendments
Health Care Amendments
Amendment 1 - Medical OOP Max
Amendment 2 - Pediatric Dental and Vision
Amendment 3 - Smoking Cessation
Amendment 4 - January 2016 changes
Amendment 5 - Welfare Subrogation
Amendment 6 - Local 321 Annual OOP
Amendment 7 -  Contributions for Local 518 Employees
Amendment 8 - Hearing Aids, Speech Therapy, and Genetic Testing
Amendment 9 - Scrivenor Error Corrections
Amendment 10 - claim denial and appeals
Health Care Forms
Health Care Forms
Address Change Form
Accident & Sickness Claim Form
Authorization to Use or Disclose Health Information
Handicapped Verification - Michelle's Law
HIPAA Authorization Form
LDI Mail Order Form
Life Insurance Beneficiary Form
How to Use the Anthem Website
Ullico Proof of Death
Subrogation Agreement
Local 321 Vital Form
Gold Plan Spousal Coverage Verification Form
Vital Form - All Locals Except 321 and 577
Universal Beneficiary Form
Local 577 Vital Form
COBRA All Locals except 577 and 321
COBRA Locals 577 and 321 ONLY
Health Care Recent Mailings
Health Care Recent Mailings
Gene Therapy Exclusion SMM- Effective 11/01/2019
Self-Pay Reduction SMM - Effective 01/01/2020
TruHearing SMM - Effective 12/12/2020
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Dentacare M Plan SPD - Actives
Health & Welfare Summary Plan Description (SPD) 2014
Summary of Benefits and Coverages (SBC) - Platinum Plan
Summary of Benefits and Coverages (SBC) - Gold Plan
Anthem Member Disclosure
Retiree Dental Rate change Effective November 2019
SMM November 2014 - Smoking Cessation-OOP Max-Ped Dental Vision-EGWP Provider
SMM January 2016 - Telemedicine, RX Benefit, Retiree Dental, Orthodontic coverage, New Trustee, New Fund Counsel
SMM January 2016 - Gold Plan Spousal Coverage
SMM March 2016 - Mandatory Generic Program
SMM May 2017 - Specialty Medications
SMM May 2017 - Hearing Aid Benefit
SMM May 2017 - Speech Therapy and Genetic Testing
SMM July 2017 - Specialty Medications
SMM October 2018 - ESI Implementation
SMM October 2019 - Gene Therapy  Exclusion
SMM 12 2019 Self-pay reduction
TruHearing Flyer
Summary Annual Report
Summary Annual Report
SAR PYE 2018
Retiree Health Care Forms
Retiree Health Care Forms
Retiree Healthcare Election Form - All Locals Except 321 & 577
Retiree Dental Election Form
Retiree Authorization for H&W Deduction
Coronavirus COVID-19 information
Coronavirus COVID-19 information
IWSTLDC COVID-19 Memo
COVID-19 Fact Sheet
LiveHealth Flyer