Monday, January 19, 2026

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
2026 Open Enrollment
Nelson Trust Benefits Guide 2025
2025 Transition to New Pharmacy Provider
Newsletters
Newsletters
Nelson News 10-2025
Nelson News 10-2025 Spanish
Nelson News 11-2024
Nelson News 10-2023
Health Care Forms
Health Care Forms
Enrollment Form Revised 8.1.2024
Enrollment Form - (Spanish) Updated 8.1.24
Authorization Form for Release of PHI
Premera PHI Non-Disclosure Request
Accident and Sickness Form
Premera Other Coverage Questionnaire Enrollment
HRA Claim Form
Beneficiary Form
2025 Working Spouse Insurance Inquiry Form
2025 Working Spouse Insurance Inquiry Form (Spanish)
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Summary Plan Description
Delta Dental
Summary of Material Modification 2024
Summary of Material Modification - Active Medical, Pharmacy, Life, Insurance Changes January 2022
Summary of Material Modification - Pre-Retiree Medical, Pharmacy, Life, Insurance, Changes January 2022
Summary of Material Modification - Active Medical, Pharmacy, Life Insurance Changes January 2021
Summary of Material Modification - Retiree-Medical, Pharmacy, Life Insurance Changes January 2021
Summary of Material Modification- Active- Medical, Pharmacy, Life Insurance Changes Janurary 2020
Summary of Material Modification- Early Retirees- Medical and Pharmacy Changes January 2020
Summary of Material Modifications- Medical, Dental, Pharmacy Plan Changes January 2018
Summary of Material Modifications- Express Scripts July 2017
Summary of Material Modifications- Medical Benefit Changes January 2014
Uniform Glossary of Health Coverage and Medical Terms
Notice Regarding Patient Protections Against Surprise Billing
Benefit Booklet
2025 Summary of Benefits & Coverage (SBC)
2025 IAM Delta Dental Plan Summary
2025 Nelson Trust Delta Dental Plan Summary
VSP Member Benefit Summary
MedImpact Preferred Drug List 7.1.2025
2026 Summary of Benefits & Coverage (SBC)
The Nelson Trust 2025 Active Participant and Non-Medicare Retiree Plan (Premera)
Notices
Notices
2025 Open Enrollment Notice
2024 Annual Notice Cover Letter
CHIP Notice 2024
Medicare Part D Annual Notice 2024
Women's Health Care Notice 2024