Thursday, January 16, 2025

Health Care Documents

Summary of Benefits and Coverages
Summary of Benefits and Coverages
SBC 2025 Active Participants
SBC 2025 SHOP Participants
SBC 2025 Medicare Supplement
SBC 2025 Medicare Advantage
Core Pre-certification List Effective: 4.1.2024
SBC 2024 Active Participants
SBC 2024 SHOP Participants
SBC 2024 Medicare Supplement
SBC 2023 Active Participants
SBC 2023 SHOP Participants
SBC 2023 Medicare Supplement
SBC 2022 Active Participants
SBC 2022 SHOP Participants
SBC 2022 Medicare Supplement
SBC 2020 UHC & EGWP Medicare Advantage
SBC 2020 Medicare Retiree PDP Supplemental
SBC 2020 Supplemental Retiree No Rx
SBC 2020 SHOP
SBC 2020 Active & Early Retirees
Summary Plan Description
Summary Plan Description
2022 Summary Plan Description
2022 Summary Plan Description SMMs
Health Care Amendments and Changes
Health Care Amendments and Changes
1st Amendment
2nd Amendment
3rd Amendment
Health Care Recent Mailings and Notifications
Health Care Recent Mailings and Notifications
CMRCC Welfare Merger January 1, 2025 SMM
Mother & Newborns/HIPAA Privacy Mailing
Ohio Carpenters GPL-1 SMM
Ohio Carpenters SMM TruHearing Clarification
SHOP Open Enrollment 7.1.24
2024 Notice of Creditable Coverage
Ohio Health Notice to Participants SMM Addition 2
Ohio Carpenters SMM TruHearing/Rate Increase
2023 Summary Annual Report
Ohio Health Notice to Participants SMM 2
COBRA Rate Increase 2024
Ohio Health Notice to Participants SMM
2022 Summary Annual Report
January 1, 2023 Transition to Level Care 2
2023 Notice of Creditable Coverage
MDLive Flyer
January 1, 2023 Transition to Level Care
COBRA Rate Increase 2023
2022 Notice of Creditable Coverage
2021 Summary Annual Report
No Surprises Act Billing Notice
Ohio Carpenters Mobile App
Over the Counter COVID Testing Guidelines
COBRA Rate Increase 2022
Antibody Testing Phase Two Mailing
2021 Credible Coverage Mailing
Cleveland Clinic Virtual Second Opinion
COVID Antibody Testing Announcement
Summary Annual Report: Health Plan
Labor First COVID-19 Announcement
Rate Increase Mailing 4-1-20
COBRA Mailing Increase 2-1-20
PDP Supplemental Plan Mailing 1-1-20
Summary of Material Modifications: Shop Plan
2018 - Summary of Material Modifications
2018 Summary Annual Report
2017 - Notice of Creditable Coverage
Vision Reimbursement Benefit
Rate Increase  -  Retirees on EGWP
2015 Summary of Material Modifications
2016 Rate Increase
Required Communications with Rawlings
Health Care Forms
Health Care Forms
New Member Package (Active)
New Member Package (SHOP)
Vital Information Form/Update Beneficiary
Express Scripts New Rx Physician Fax Form
HIPAA Authorization Form
Vital Information and HIPAA Authorization Form Instructions
Disability Form
Auto Deduction Form (Active)
Auto Deduction Form (Retiree)
HRA Form
Retiree Application Form
Express Scripts Mail Order Form
Reciprocity Form
Reimbursement Card Transaction Dispute Form
Health Care Documents
Health Care Documents
Teladoc Flyer General
Teladoc Flyer Dermatology
Teladoc Flyer Behavioral Mental Health
Dental Benefits Summary
Dental Oral Health Bites 2021 Calender
COVID-19 Resource
Live Health Online Registration Guide
Live Health Online Instructions
Avoid Balance Billing - Consumers Guide
ASO and JAA Member Disclosure
HIPAA Privacy Notice