Summary Plan Description Booklets
Summary Plan Description
Summary of Benefits and Coverage
2023 – 2024 SBC
Benefit Summaries
Benefit Summary
Downloads and Forms
Enrollment Form for Cafeteria Workers
Enrollment Form for Climate Staff
HIPAA Authorization Form
Vision Benefits of America Member Portal
Vision Benefits of America ID Card
BeneCard PBF Central Fill Mail Service Order Form
BeneCard Direct Member Reimbursement Form
BeneCard PBF Mobile App
HIPPA Notice of Privacy Practices
Useful Links
Guardian Nurses
Louis P. Mattucci & Associates
Philadelphia Podiatrist
Useful Numbers
Fund Office: (833) 228-9212
Guardian Nurses: (215) 836-0260
Louis P. Mattucci & Associates: (215) 364-6500
Philadelphia Podiatrist: (215) 923-2455
BeneCard Prescription Benefit Facilitator: (1-888) 907-0070 TDD: (1-888) 907-0020
IMPORTANT HEALTH COVERAGE TAX DOCUMENTS
Prior to tax year 2025, you automatically received a copy of IRS Form 1095-B via postal mail. This form shows proof of your minimum essential health coverage for the most recent tax filing year. However, due to recent changes in federal law, Form 1095-B is no longer required to be mailed to individuals under IRS rules, except upon request. The IRS no longer requires you to include a copy of 1095-B with your annual federal tax return, but you are still entitled to request a copy for your records.
If you would like to receive a copy of your 1095-B showing coverage under the School Cafeteria Employees UNITEHERE Local No. 634 Health and Welfare Fund for the most recent tax filing year, you may request a copy by calling 833-228-9212, emailing 1095BRequests@associated-admin.com or sending a written request to the Fund Office at 911 Ridgebrook Road, Sparks MD 21152. A copy of your Form 1095-B will be mailed to you within 30 days of receiving your request.
