Lithographers and Photoengravers Local 285
Revised Notice of Privacy Practices
Downloads (Forms)
HIPAA Authorization Form
Mutual of Omaha Enrollment Form
Kaiser Permanente Member Reimbursement Form
Summary Plan Description Booklets
Summary of Benefits And Coverage
2022 – 2023 SBC – Select DHMO 8
2022 – 2023 SBC – Select DHMO 16
2022 – 2023 SBC – Signature HMO
CIGNA DHMO
Carriers
Kaiser Health Plans
National Vision Administrators
Graphic Communications National Health and Welfare Fund
Mutual of Omaha
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.
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.