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Glossary of Health Coverage and Medical Terms
Local 1500 – Surprise Billing Public Notice
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Full-Time Medical Plan (FT)
Provider Locator: Anthem.com or 1-800-810-BLUE
Provider contact for benefit verification: 1-800-676-BLUE
Member contact: Associated Administrators, LLC 1-855-266-1500
Pre-certification of services: Healthlink Medical Management: 1-877-284-0102
Mental Health/Substance Abuse pre-certification through LICADD: 1-516-747-2606
(Long Island Council on Abuse and Drug Dependence)
Prescription Plan Information: Express-Scripts.com or 1-877-861-8145
Download FT Plan Forms
Full-Time Plan – Change of Address Form
Full-Time Plan – Spousal Enrollment Form
Full-Time Plan – Preventive Services Benefit List
Full-Time Plan – Subrogation Agreement
Full-Time Plan – Coordination of Benefits Questionnaire
Full-Time Plan – Third Party Change of Address Form
Hand-outs from Feb 2014 area meetings
Summary of Material Modifications (SMMs)
Increase to Dental & Optical Benefits
CHANGES TO YOUR PRESCRIPTION DRUG BENEFIT
Full-Time Plan – Summary of Material Modifications – October 1, 2023
Full-Time Plan – Summary of Material Modifications – November 1, 2022
Full-Time Plan – Summary of Material Modifications – March 1, 2021
Full-Time Plan – Summary of Material Modifications – March 1, 2020
Full-Time Plan – Summary of Material Modifications – March 27, 2020
Full-Time Plan –Summary of Material Modifications – November 1, 2019
Full-Time Plan – Summary of Material Modifications – October 17, 2019
Full-Time Plan – Summary of Material Modifications – October 31, 2018
Full-Time Plan – Summary of Material Modifications – February 28, 2018
Full-Time Plan – Summary of Material Modifications – February 28, 2018 (Spanish)
Full-Time Plan – Summary of Material Modifications – July 21, 2015
Full-Time Plan – Summary of Material Modifications – February 1, 2015
Full-Time Plan – Summary of Material Modifications – December 29, 2014
Full-Time Plan – Summary of Material Modifications – October 2, 2014
Full-Time Plan – Summary of Material Modifications – December 30, 2013
Summary of Benefits and Coverage (SBC)
Full-Time Plan Coverage Period January 1 – December 31, 2024
Summary Plan Description Booklet
Full Time Employees Group Benefit Plan
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Special Part-Time Medical Plan (SPT)
Summary Plan Description Booklet
Summary Plan Description Booklet – Special Part-Time
Provider Locator: Anthem.com or 1-800-810-BLUE
Benefit Information: Associated Administrators, LLC: 1-855-266-1500
Prescription Plan Information: Express-Scripts.com or 1-877-861-8145
Pre-certification Services: Healthlink Medical Management: 1-877-284-0102
Download SPT Plan Forms
Special Part-Time Plan – Change of Address Form
Special Part-Time Plan – Preventive Services Benefit List
Special Part-Time Plan – Subrogation Agreement
Special Part-Time Plan – Coordination of Benefits Questionnaire
Special Part-Time Plan – Third Party Change of Address Form
Hand-outs from Feb 2014 area meetings
Summary of Material Modifications (SMMs)
Increase to Dental & Optical Benefits
CHANGES TO YOUR PRESCRIPTION DRUG BENEFIT
Special Part-Time Plan – Summary of Material Modifications – October 1, 2023
Special Part-Time Plan – Summary of Material Modifications – November 1, 2022
Special Part-Time Plan – Summary of Material Modifications – March 1, 2021
Special Part-Time Plan – Summary of Material Modifications – March 1, 2020
Special Part-Time Plan – Summary of Material Modifications – March 27, 2020
Special Part-Time Plan – Summary of Material Modifications – November 1, 2019
Special Part-Time Plan – Summary of Material Modifications – October 31, 2018
Special Part-Time Plan – Summary of Material Modifications – July 1, 2015
Special Part-Time Plan – Summary of Material Modifications – April 30, 2015
Special Part-Time Plan – Summary of Material Modifications – February 1, 2015
Special Part-Time Plan – Summary of Material Modifications – December 29, 2014
Special Part-Time Plan – Summary of Material Modifications – September 30, 2014
Special Part-Time Plan – Summary of Material Modifications – December 30, 2013
Summary of Benefits and Coverage (SBC)
Special Part-Time Plan Coverage Period January 1 – December 31, 2024
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Part-Time ACA Medical Plan (A)
Summary Plan Description Booklet
Part Time ACA Employees Group Benefit Plan
Useful Numbers
Provider Locator: Anthem.com or 1-800-810-BLUE
Provider contact for benefit verification: 1-800-676-BLUE
Member contact: Associated Administrators, LLC 1-855-266-1500
Pre-certification of services: HealthLink Medical Management: 1-877-284-0102
Mental Health/Substance Abuse services through LICADD: 1-516-747-2606
(Long Island Council on Abuse and Drug Dependence)
Prescription Plan Information: Express-Scripts.com or 1-877-861-8145
Download PT ACA Plan Forms
Part-Time ACA Plan – Change of Address Form
Part-Time ACA Plan – Third Party Change of Address Form
Part-Time ACA Plan – Preventive Services Benefit List
Part-Time ACA Plan – Subrogation Agreement
Part-Time ACA Plan – Outline of Benefits
Summary of Material Modifications (SMMs)
Increase to Dental & Optical Benefits
CHANGES TO YOUR PRESCRIPTION DRUG BENEFIT
Part-Time ACA Plan – Summary of Material Modifications – October 1, 2023
Part-Time ACA Plan – Summary of Material Modifications – November 1, 2022
Part-Time ACA Plan – Summary of Material Modifications – March 1, 2021
Part-Time ACA Plan – Summary of Material Modifications – March 1, 2020
Part-Time ACA Plan – Summary of Material Modifications – March 27, 2020
Part-Time ACA Plan – Summary of Material Modifications – November 1, 2019
Part-Time ACA Plan – Summary of Material Modifications – October 31, 2018
Part-Time ACA Plan – Summary of Material Modifications – July 21, 2015
Part-Time ACA Plan – Summary of Material Modifications – December 29, 2014
Summary of Benefits and Coverage (SBC)
Part-Time ACA Plan Coverage Period January 1 – December 31, 2024
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Download Basic Part-Time Forms
Part-Time Plan – Change of Address
Part-Time Plan – Third Party Change of Address Form
Summary Plan Description Booklet
Part-Time Plan – Part Time Employees Group Benefit Plan
Summary of Material Modifications (SMMs)
Increase to Dental & Optical Benefits
Full-Time Plan – Summary of Material Modifications – March 1, 2021
Part-Time Plan – Summary of Material Modifications – March 1, 2020
Part-Time Plan – Summary of Material Modifications – October 31, 2018
Part-Time Plan – Summary of Material Modifications
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Useful Links
New York State – The Official Health Plan Marketplace
WorldDiabetesMonthToolkit CS version
Local 1500 Welfare Fund ESI Covid-19 Test Kits Information
Dental Providers
Local 1500 SMM for Dental, Ortho, and Optical
Integrated Dental Administrators, Inc.
1-855-UFCW-1500
DDS, Inc
1-800-255-5681
Vision Providers
Vision Fee Schedule Effective 03.01.21
General Vision Services Website
General Vision Benefits & Provider Locations
Vision Screening Inc. Brochure
Transparency in Coverage: Machine Readable Files
The links below lead to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and include negotiated service rates between health plans and healthcare providers. The machine readable files are formatted to allow researchers, regulators and application developers to more easily access and analyze data.
In-Network Machine Readable File
UFCW Local 1500 Allowed Amounts Machine Readable File
These forms are published on this page by Associated Administrators, LLC on behalf of the Client Fund and are meant solely for the use of their participants.