Bakers Union & FELRA

Downloads (Forms)

Bakers – Approved Surprise Billing Public Notice
Bakers Union and FELRA Enrollment form
Statement of Privacy
Student Certification Form
Subrogation Agreements
Weekly Accident and Sickness Claim Form
covid-19-test-kit-reimbursement-form
Delta Dental Evidence of Coverage
2022 Premium Formulary Exclusions – Standard
2022 Premium Standard Formulary – Booklet

For Your Benefits Newsletter

April 2021
October 2019
April 2019
September 2018
September 2017
March 2017
September 2016
December 2013
January 2013
July 2012
January 2012
July 2011

 Summary Plan Description Booklets

Bakers Union and FELRA Health and Welfare SPD
SMMs (Benefit Changes) to Health & Welfare SPD

Useful Numbers

Delta Dental: 1-800-932-0783

Useful Links

CIGNA HealthCare
Care Allies
Optum Rx
Premium Formulary
Delta Dental
Group Vision Services

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.