Funds

Health/Welfare

Health & Welfare Documents

This exhibit summarizes the major provisions of the Health and Welfare Plan.  It is not intended to be, nor should it be interpreted as, a complete statement of all plan provisions. 

Please note that the information presented is subject to change.  Contact the Fund Office for verification of current benefits.

 

Your Privacy: 

Click here to view the Health and Welfare fund Privacy Statement in Word

Click here to view the Health and Welfare fund Privacy Statement in PDF Format*

 

Summary Plan Description*     

Health Reimbursement Arrangement SPD*    


 Summary Annual Reports: *


Accident Report

Claims Review/Appeal Procedures

Procedures to Request Certificate of Group Health Plan Coverage Procedures

PPO Claim Form

Retiree HRA Claim Form
(Over age 65)

Non PPO Claim Form (For use when applying for Loss of Time benefits)

Vision Care Benefits

Dental Care Benefits

W-4 for use when applying for Loss of Time benefits

Other Coverage Update Form

Related Links

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EyeMed

Envision/RX Options

Lab Tests Online

Agency for Healthcare Research

 

 

Important Phone Numbers