Benefits Office

WELFARE (MEDICARE PARTICIPANTS 65 & OVER)

Welfare Summary Plan C Description - Medicare / 65 & Over

Forms

Authorization for Release of Health Information
Claim Reimbursement Form
Dental Out-of-Network Member Claim Form
Letter of Medical Necessity Template
Notice of Privacy Practices Form
Waiver of Coverage Form

 



Benefits / Resources

COBRA Coverage (See Section C - "COBRA CONTINUATION COVERAGE")

Death

Dental

Hearing

Retiree First

Medical

Medicare & Prescription Drug (MAPD)

Medicare-B Reimbursement (See Section "Medicare Part B Premium Reimbursement")

Vision


 
FAQs (Click Here)