Wednesday, April 1, 2026

Health Care Documents

Health Care Recent Mailings
Health Care Recent Mailings
396 H&W Summary Annual Report for Year Ending 3/31/2025
P&P Health & Welfare Local 396 2025 Annual Notice
Local 396 SMM - Anthem Effective 1/1/2026
Anthem Find Care Flyer
Anthem.com and Sydney Registration
Notice to Member re Anthem 12/1/2025
Summary of Benefits & Coverage 1/1/2026 - 12/31/2026
Local 396 SMM: Special Enrollment and 2nd & 3rd Medical Opinions
Health Care Forms
Health Care Forms
Vital Form
Application for Early Retirement and-or Permanent Disability
Medical Reimbursement Form
Short Term Disability Claim Form
H&W Pension Deduction Form
Summary of Material Modifications
Summary of Material Modifications
Local 396 SMM - 2023 COVID Emergency End
Local 396 SMM - 2022 COVID Testing to Members
Local 396 SMM -11/2024 MRA Forfeiture & Fees Incurred for Administering or Injection Prescription Drugs
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Summary Plan Description 2022
Glossary of Health Coverage & Medical Terms
HIPAA Portability Rights
Non-Discrimination Notice
Form 1095-B Request Instructions
Notice of Privacy Practices (updated 2/9/2026)
Employee Assistance Program - Anthem
Summary of Benefits and Coverages
Summary of Benefits and Coverages
Summary of Benefits & Coverage 1/1/2026 - 12/31/2026
1/1/2024 VSP Vision Benefit Summary