Summary Plan Description Booklet (“SPD”)

Warehouse Employees Union Local No. 730 Health and Welfare SPD
SMMs (Benefit Changes) to the 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
QDRO 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
2022 Summary of Benefits & Coverage
Surprise Billing Public Notice

Notice of Critical Status

Annual Funding Notice

For Your Benefit Newsletters

September 2018
January 2018
September 2017
April 2017
January 2017
October 2016
July 2016
April 2016
February 2016
October 2015
July 2015
April 2015
January 2015
October 2014
April 2014
January 2014
October 2013
July 2013

 

Useful Links

Care Allies Precertification
CareAllies 24 – Hour Nurseline
CIGNA HealthCare
CIGNA Rx
CIGNA Centrix (DME)
Preventive Services List
Metlife

 

Useful Numbers

Care Allies Precertification – 800-768-4695
CareAllies 24 – Hour Nurseline – 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.

Machine Readable File links are forthcoming. Please check back soon.

In-Network 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.