Tuesday, February 3, 2026

Health Care Documents

Machine Readable File - In Network and Out-of Network
Machine Readable File - In Network and Out-of Network
Click here to access In Network and Out of Network Machine Readable Files.  To access the files, under NW Ohio Plumbers, copy the locations for each of the files into your browser. The allowed_amount_file is the out of network file.
Health Care Forms
Health Care Forms
Address Verification Change Form
Short Term Disability Benefits Application Form
Status Change Form
Vital Information Form
Summary of Benefits and Coverage 2024
Summary Annual Report - Active HW
Summary Plan Description & Plan Document
Summary Plan Description & Plan Document
Plan Document - 2014
Summary Plan Description - Effective - 01 01 2024
Health Care Notices
Health Care Notices
COVID 19 Benefits
Notice of Non-Discrimination
Notice of Privacy Practices
BeneSys NSA balance billing notice
2023 Optum RX Premium Standard Formulary List
Dental Benefits - www.DeltaDentalOH.com  PH: 800-524-0149
Dental Benefits - www.DeltaDentalOH.com  PH: 800-524-0149
Delta Dental - Benefit Summary
Scheduling Your Preventive Dental Visit
The Benefits of Staying In Network
Member Resources
Vision Benefits - www.eyemed.com  PH: 866-804-0982
Vision Benefits - www.eyemed.com  PH: 866-804-0982
Vision Benefit Summary
What's New at EyeMed
EyeMed Special Offers
Hearing Discount with EyeMed
How to Use Safety Eyewear Program
Safety Eyewear Benefits - Effective 1-1-2021
Enhanced Provider Search
EyeMed Member 2022 Special Offers Flyer
EyeRewards Member Flyer
Know Before You Go Member Flyer
Mobile App and Text Alert Flyer
Mobile Chat and Online Options
Power of an Eye Exam Wellness Article
Retail Chains - Insight
EAP Benefits - https://nwopp50.mysupportportal.com - PH: 888-881-5462
EAP Benefits - https://nwopp50.mysupportportal.com - PH: 888-881-5462
Counseling Benefits