Tuesday, March 3, 2026

Health Care Documents

Machine Readable File - HAP In Network
Machine Readable File - HAP In Network
Machine Readable File Landing Page
Machine Readable File Out of Network
Machine Readable File Out of Network
Out of Network - MRF
Health Care Recent Mailings
Health Care Recent Mailings
HPA Couponing Program
Benny Card Update
Insurance Plan Changes Effective September 1, 2022
Summary of Material Modifications - August 2023 (14th Amendment)
Summary of Material Modifications - Weight Loss Drugs Coverage
Updated 2024 Actives/Early Retirees SBC
Delta Dental Transition Notice
TruHearing Transition Notice
Plumbers Local 98 Insurance Fund Prior Authorizations SMM
Aflac Cybersecurity Breach - 2025
Notice of Pharmacy Benefits Manager Change - 2025
Humana Medicare Retirees - ESI Error Letter
Notice of Creditable Coverage - 2025
Women's Health Annual Notice - 2025
2026 1095B Notice
Health Care Forms
Health Care Forms
Vital Information Form
HIPAA Form
Statement of Health Form for Additional Life Insurance
HRA Reimbursement Form
Life Insurance Enrollment Form
Reimbursement Card Transaction Dispute Form
Aflac Informational Flyers (Opt-Outs Only)
COBRA Subsidy Application
Sun Medical Equipment & Supplies Flyer
Rx iV Pharmacy
TruHearing Flyer
HIPAA Notice of Privacy Practices
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
Local 98 Summary Plan Description 2021
Active Member Supplemental Life Monthly Premium
2023 Insurance Plan Document
Work Life Strategies - Employee Assistance Program Flyer
SVS Brochure (Opt-Outs Only)