Summary Plan Description Booklets
Health & Welfare Plan SPD
SMMs (Benefit Changes) to the Health & Welfare Plan SPD

Summary Of Benefits & Coverage
2023 SBC Full Plan (Shop)
2019 SBC Partial Plan (Shop)

2023 SBC Full Plan (Exhibitor)
2023 SBC Partial Plan (Exhibitor)

Useful Numbers
Express Scripts – 1-800-451-6245
Independence Administrators – 1-888-234-2393
Provider Information – 1-800-810-BLUE
Inpatient Stay Precertification and Durable Medical Equipment – 1-888-234-2393
Cigna Dental – 1-800-797-3381

Useful Links
Carefirst PPO
Cigna Dental
Independence Administrator

Accident & Sickness Form
Coordination of Benefits Form
Enrollment Form
Optical List & Fee Schedule

HIPAA Authorization Form


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.

Local 491 Machine Readable Files

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.