Thursday, May 6, 2021

Health Care Documents


Health Care Amendments and Changes
Health Care Amendments and Changes
Particpant Notice Out-of-Pocket Limits
Health Care Forms
Health Care Forms
Medical Claim Form
Total Disability Form
2020 Dental/Vision Reimbursement Claim Form
2021 Dental/Vision Reimbursement Claim Form
Enrollment Form
Coordination of Benefits (COB) Form
Health Care Recent Mailings
Health Care Recent Mailings
Notice to Retirees (Post-1998) Retiree Rates Effective January 1, 2016 Marketplace
2016 Utah Pipe Trades Welfare Trust New Plan Document and SPD Notice
Annual Notification Women's Health and Cancer-Rights Act of 1998
Children's Health Insurance Program Notice
Privacy Practices Notice
Notice of Benefit Modifications 2018
Creditable Coverage (Medicare Pard D) Notice
Updates to Claims Procedures Notice
Teladoc Benefit Notice
Retiree Self-Pay Rates Effective 05/01/19 Notice
Summary Annual Report YE 2018
Revised Retiree Rates eff 5-1-2020
COVID-19 Notice
SMM change in eligibility rules for new Participants
COVID 19 COBRA Notice 2020
Long Term COVID-19 impact article
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
2016 Utah Pipe Trades Welfare Trust Fund Summary Plan Description
Summary of Benefits and Coverage
Consumer Guide on Avoiding Balance Billing