Tuesday, February 10, 2026

Health Care Documents

Health Care Enrollment Packet
Health Care Enrollment Packet
Welcome Letter
Vital Information Form
Dependent Coverage Instructions
Privacy Practices
Authorization Form Instructions
Protected Health Information Form
MetLife Beneficiary Form
Pension Beneficiary Form
BCBS MI Mobile App Flyer
BCBS MI Preventative Prescription Drug List
Delta Dental Plan Benefits
DC Plan 401(k) Empower Beneficiary Form
Davis Vision Benefits
Supplemental Unemployment Benefit (SUB) Summary Plan Description (SPD) v. 2017
SUB Plan Payee Direct Deposit Form
IHRA Pre Authorization Form
Language Assistance
Health and Welfare (SPD) v. 2017
Self-Pay/COBRA Rates effective April 1, 2025
Pension Summary Plan Description (SPD) v. 2017
Defined Contribution 401(k) Plan Summary Plan Description (SPD) v. 2017
Scholarship Plan Summary Plan Description (SPD) v. 2017
COBRA Rights
IHRA Claim Reimbursement Form
Health Care Recent Mailings
Health Care Recent Mailings
Participant Website Announcement - Actives
Participant Website Announcement - Retirees
Summary Plan Description (SMM) Self-Pay/COBRA Rates
Summary of Benefits and Coverages - Enhanced
Summary of Benefits and Coverages - Standard
Privacy Practices
No Surprise Medical Bill
Third Party Administrator - Change Notification Letter 020425
Health Care Amendments and Changes
Health Care Amendments and Changes
Out of Pocket Maximums effective 060124-053125
Medicare Retiree Prescription Amendment eff 010122
Non-Bargaining Unit Employee Coverage
CARES Act Amendment
COVID Test Coverage 011522
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
2026 Standard Coverage
2026 Enhanced Coverage
Final HW SPD
2026 Annual Physical Verification Form
Mental Health Contacts
Benefit Fund Contact Information
Benefit Fund Contact Information
Health & Welfare Plan Contact Information