Active Health & Welfare – Plan Documents & Forms
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Plan Documents & Amendments
Enrollment
Summary of Benefits & Coverage
Active HW – Plan A
Plan A – Anthem SBC
Plan A & Plan K20 SBC
Active HW – Plan B
Plan B – Anthem SBC
Plan B & Plan K500 SBC
Active HW – Plan C
Plan C – Anthem SBC
Plan C & K1000 SBC
General Forms
General Notices
Summary of Material Modifications & Plan Notices
October 2023 – Mental Health & Substance Use Disorder Benefits
June 2023 – Medical Benefits Pursuant to the End of the COVID-19 Emergency
March 2023 – Physical Exam Required to Keep Lower Deductible Level for 2024 Calendar Year
January 2022 – Deductible Decrease for Indemnity Plans A, B or C
February 2022 – Clarification regarding Calculating Disability Pay Effective September 1, 2019
Effective January 1, 2022 – Increase to Orthodontic Maximum for Participants & their Dependents (including COBRA Beneficiaries)