Summary Plan Description Booklet (“SPD”)
Warehouse Employees Union Local No. 730 Health and Welfare SPD
Downloads (Forms)
Accident Inquiry Form
CIGNA Rx – Reimbursement Claim Form
Coordination of Benefits Form
Change in Beneficiary for Life Insurance Benefit (A Health and Welfare Benefit)
Enrollment Form
HIPAA Authorization Form
Assignment and Subrogation Agreement
Weekly Accident and Sickness Claim Form
Federal Tax Withholding Form (Pension)
State Tax Withholding Form (Pension)
MetLife Benefit Summary
Important Notices
Notice of Privacy Practices
2024 Summary of Benefits & Coverage
Surprise Billing Public Notice
Change Healthcare Notice to Members
Useful Links
Care Allies Precertification
CIGNA HealthCare
CIGNA Rx
CIGNA Centrix (DME)
Preventive Services List
Metlife
Warehouse Local 730 H&W Fund Price Comparison Tool
Useful Numbers
Care Allies Precertification – 800-768-4695
CIGNA HealthCare – 800-768-4695
CIGNA Rx – 800-244-6224
CIGNA Centrix (DME) – 800-244-6224
Dental Health Centers and Associates – 888-802-6970
Group Vision Services (GVS) – 866-265-4626
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.
Warehouse Employees Union Local No. 730 In-Network File
Warehouse Employees Union Local No. 730 Allowed Amounts 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.