| Title | Category | View File |
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Data Card
|
Data Card
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Download
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Summary Plan Description for Base, Alternative, and Retiree Plans
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Welfare Trust Fund SPD & Plan Document
|
Download
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Summary Plan Description for Base, Alternative, and Retiree Plans - Cover Letter
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Welfare Trust Fund SPD & Plan Document
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Download
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2022 Schedules of Benefits
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Welfare Trust Fund SPD & Plan Document
|
Download
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Welfare SPD/PD Amendment 1
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Welfare Trust Fund SPD & Plan Document
|
Download
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Welfare SPD/PD Amendment 2
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Welfare Trust Fund SPD & Plan Document
|
Download
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Welfare SPD/PD Amendment 3
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Welfare Trust Fund SPD & Plan Document
|
Download
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Welfare SPD/PD Amendment 4
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Welfare Trust Fund SPD & Plan Document
|
Download
|
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Welfare Trust Agreement Sept 2022
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Welfare Trust Fund Documents
|
Download
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Summary Plan Description for Base, Alternative, and Retiree Plans
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Retiree SPD
|
Download
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Summary Plan Description for Base, Alternative, and Retiree Plans - Cover Letter
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Retiree SPD
|
Download
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2023 GHP Model Disclosure Notice Regarding Patient Protections Against Surprise Billing
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No Surprises Act
|
Download
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Request for Continuity of Care Benefits and Release of Information
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No Surprises Act
|
Download
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Pension Trust Fund Plan Document 2018
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Trust Fund SPD 2018
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 1
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 2
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 3
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 4
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 5
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 6
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 7
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Pension Trust Fund SPD & Plan Document
|
Download
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Pension Plan Document Amendment 8
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Pension Trust Fund SPD & Plan Document
|
Download
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January 2023 Newsletter
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Current Newsletter
|
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June 2022 Newsletter
|
Archived Newsletters
|
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December 2021 Newsletter
|
Archived Newsletters
|
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July 2021 Newsletter
|
Archived Newsletters
|
Download
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December 2020 Newsletter
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Archived Newsletters
|
Download
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December 2019
|
Archived Newsletters
|
Download
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January 2019
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Archived Newsletters
|
Download
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June 2019
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Archived Newsletters
|
Download
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June 2018
|
Archived Newsletters
|
Download
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December 2017
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Archived Newsletters
|
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June 2017
|
Archived Newsletters
|
Download
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December 2016
|
Archived Newsletters
|
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June 2016
|
Archived Newsletters
|
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December 2015
|
Archived Newsletters
|
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June 2015
|
Archived Newsletters
|
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December 2014
|
Archived Newsletters
|
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June 2014
|
Archived Newsletters
|
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November 2013
|
Archived Newsletters
|
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June 2013
|
Archived Newsletters
|
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December 2012
|
Archived Newsletters
|
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June 2012
|
Archived Newsletters
|
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December 2011
|
Archived Newsletters
|
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June 2011
|
Archived Newsletters
|
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December 2010
|
Archived Newsletters
|
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June 2010
|
Archived Newsletters
|
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December 2009
|
Archived Newsletters
|
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June 2009
|
Archived Newsletters
|
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December 2008
|
Archived Newsletters
|
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Other Liability Insurance Form
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Welfare Trust Fund Forms
|
Download
|
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Customer Service Consent (HIPAA Form)
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Welfare Trust Fund Forms
|
Download
|
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Spousal and Dependent Insurance Form
|
Welfare Trust Fund Forms
|
Download
|
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Special Dependent Enrollment Form
|
Welfare Trust Fund Forms
|
Download
|
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Specific Information Release
|
Welfare Trust Fund Forms
|
Download
|
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Beneficiary Designation Form - Welfare Trust Fund
|
Welfare Trust Fund Forms
|
Download
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Direct Transfer Form
|
Welfare Trust Fund Forms
|
Download
|
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Hours Transfer Form
|
Welfare Trust Fund Forms
|
Download
|
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Contribution Rate effective June 1, 2017
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Welfare Trust Fund Documents
|
Download
|
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Epic Hearing Service Plan
|
Welfare Trust Fund Documents
|
Download
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Privacy Policy
|
Welfare Trust Fund Documents
|
Download
|
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EPIC Hearing Healthcare
|
Welfare Trust Fund Documents
|
Download
|
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COBRA Notice Base Plan
|
COBRA
|
Download
|
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COBRA Notice Alt Plan
|
COBRA
|
Download
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COBRA Notice Single Alt Plan
|
COBRA
|
Download
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Notification of Qualifying Event
|
COBRA
|
Download
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Member Accident Form
|
Accident Forms
|
Download
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Subrogation Agreement and Loan Agreement
|
Accident Forms
|
Download
|
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Spouse Accident Form
|
Accident Forms
|
Download
|
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Dependent Accident Form
|
Accident Forms
|
Download
|
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Physician's Statement for Loss of Time from Work
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Accident Forms
|
Download
|
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HRA Benny Card Participant Guide
|
HRA Documents
|
Download
|
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How to Use Your Benny Card
|
HRA Documents
|
Download
|
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How to Use the HRA Mobile App
|
HRA Documents
|
Download
|
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Benny Card Terms & Conditions
|
HRA Documents
|
Download
|
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How to Login to the HRA Participant Portal
|
HRA Documents
|
Download
|
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HRA Eligible Expenses
|
HRA Documents
|
Download
|
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HRA Participant Portal User Guide
|
HRA Documents
|
Download
|
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HRA Reimbursement Terms & Conditions
|
HRA Documents
|
Download
|
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Use the Mobile App to Change Your Password
|
HRA Documents
|
Download
|
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View HRA Account Activity
|
HRA Documents
|
Download
|
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2020 Publication 502
|
HRA Forms
|
Download
|
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Direct Transfer Form
|
HRA Forms
|
Download
|
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Health Reimbursement Arrangement (HRA) Account Claim for Reimbursement
|
HRA Forms
|
Download
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HRA Direct Deposit Form
|
HRA Forms
|
Download
|
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Application for Retiree Plan
|
Retirees Forms
|
Download
|
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Authorization for Automatic Deposits
|
Retirees Forms
|
Download
|
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Request Automatic HRA Reimbursement of Retiree Premium
|
Retirees Forms
|
Download
|
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Retiree Opt-In/Opt-Out Form
|
Retirees Forms
|
Download
|
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Retiree Dental and Vision Letter
|
Retirees Forms
|
Download
|
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Direct Transfer Form
|
Retirees Forms
|
Download
|
|
Pension Trust Agreement Sept 2022
|
Pension Trust Fund Documents
|
Download
|
|
Complete Pension Benefit Application – Single
|
Pension Trust Fund Forms
|
Download
|
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Complete Pension Benefit Application – Married
|
Pension Trust Fund Forms
|
Download
|
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Application: Benefit Application and Certification
|
Pension Trust Fund Forms
|
Download
|
|
Application: Pension Application Only
|
Pension Trust Fund Forms
|
Download
|
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Advanced Determination
|
Pension Trust Fund Forms
|
Download
|
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Bargaining and Non-Bargaining Verification
|
Pension Trust Fund Forms
|
Download
|
|
Direct Deposit Form
|
Pension Trust Fund Forms
|
Download
|
|
Joint & Survivor Explanation Verification Form
|
Pension Trust Fund Forms
|
Download
|
|
Maximum Benefit Test (Section 415 Limits) Form
|
Pension Trust Fund Forms
|
Download
|
|
Notice of Return to Work
|
Pension Trust Fund Forms
|
Download
|
|
Notice of Right to Defer and Consequences of Failure to Defer
|
Pension Trust Fund Forms
|
Download
|
|
Pension Trust Fund Appeal Form
|
Pension Trust Fund Forms
|
Download
|
|
Resumption of Benefits
|
Pension Trust Fund Forms
|
Download
|
|
Sample QDRO
|
Pension Trust Fund Forms
|
Download
|
|
Waiver of Joint and Survivor Benefit
|
Pension Trust Fund Forms
|
Download
|
|
2021 W-4P
|
Pension Trust Fund Forms
|
Download
|
|
Retirement Declaration Document
|
Pension Trust Fund Forms
|
Download
|
|
Temporary Return to Work (600 Hour Rule) 2023
|
Pension Trust Fund Forms
|
Download
|
|
Pension Annual Funding Notice September 2022
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2021
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice 2020
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2019
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2018
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2016
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2015
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2014
|
Pension Annual Funding Notices
|
Download
|
|
Pension Annual Funding Notice Sept 2013
|
Pension Annual Funding Notices
|
Download
|
|
Pension Important Notice to Participants June 2022
|
Pension Summary Material Modifications
|
Download
|
|
Pension Important Notice to Participants November 2021
|
Pension Summary Material Modifications
|
Download
|
|
Pension Important Notice to Participants September 2021
|
Pension Summary Material Modifications
|
Download
|
|
Pension Important Notice to Participants December 2020
|
Pension Summary Material Modifications
|
Download
|
|
Pension Important Notice to Participants February 2020
|
Pension Summary Material Modifications
|
Download
|
|
Pension Important Notice to Participants June 2018
|
Pension Summary Material Modifications
|
Download
|
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How To Read Your EOB
|
Explanation of Benefits
|
Download
|
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How to View Your eEOB
|
Other
|
Download
|
|
BCBS Blue Access for Members
|
Other
|
Download
|
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Description of Participation Options
|
Welfare Trust Fund - Employer Information
|
Download
|
|
Health Plan Only
|
Welfare Trust Fund - Employer Information
|
Download
|
|
Health Plan and HRA
|
Welfare Trust Fund - Employer Information
|
Download
|
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Working Owner Alumni Agreement
|
Welfare Trust Fund - Employer Information
|
Download
|
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Non Construction BU Agreement
|
Welfare Trust Fund - Employer Information
|
Download
|
|
Waiver of Non-Bargaining Participation
|
Welfare Trust Fund - Employer Information
|
Download
|
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Business Information Sheet
|
Welfare Trust Fund - Employer Information
|
Download
|
|
Informational Letter to Employers - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
Waiver of Non-Bargaining Participation - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
Description of Participation Options - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
Working Owner Alumni Agreement - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
NBU Agreement Percentage of Salary - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
NBU Agreement - Pension
|
Pension Trust Fund - Employer Information
|
Download
|
|
Business Information Sheet
|
Pension Trust Fund - Employer Information
|
Download
|
|
Nondiscrimination Notice Section 1557 ACA
|
Welfare Trust Fund Documents
|
Download
|
|
Welfare Summary Annual Report 2018
|
Welfare Summary Annual Reports
|
Download
|
|
Welfare Summary Annual Report 2019
|
Welfare Summary Annual Reports
|
Download
|
|
Welfare Summary Annual Report 2020
|
Welfare Summary Annual Reports
|
Download
|
|
Welfare Summary Annual Report 2021
|
Welfare Summary Annual Reports
|
Download
|
|
PaydHealth Summary of Material Modifications
|
Welfare Summary Material Modifications
|
Download
|
|
2020 Wellness Power
|
Welfare Summary Material Modifications
|
Download
|
|
EyeMed Vision Care Benefit
|
Welfare Summary Material Modifications
|
Download
|
|
MDLIVE Summary of Material Modifications
|
Welfare Summary Material Modifications
|
Download
|
|
Welfare Trust Fund Appeal Form/Authorized Representative Form
|
Appeal
|
Download
|
|
Large Employer Letter
|
Employers
|
Download
|
|
Notice to Contributing Employers and Participating Employee Organizations
|
Employers
|
Download
|
|
Welfare Trust Agreement Sept 2022
|
Employers
|
Download
|
|
Welfare Admin Rules
|
Employers
|
Download
|
|
Welfare Collection and Payroll Audit Policy
|
Employers
|
Download
|
|
Welfare Notice to Employers dated 06/24/19
|
Employers
|
Download
|
|
Pension Trust Agreement Sept 2022
|
Employers
|
Download
|
|
Pension Admin Rules
|
Employers
|
Download
|
|
Pension Collection and Payroll Audit Policy
|
Employers
|
Download
|
|
Pension Notice to Employers dated 06/24/19
|
Employers
|
Download
|
|
COVID-19
|
Messages
|
Download
|
|
Tips to Protect Yourself and Others
|
COVID-19
|
Download
|
|
How We Can Help
|
COVID-19
|
Download
|
|
Traumatic Event Support - How Events Can Effect You
|
COVID-19
|
Download
|
|
Traumatic Event Support - Taking Care After the Event
|
COVID-19
|
Download
|
|
Traumatic Event Support - Helping your Child
|
COVID-19
|
Download
|
|
Coping with Crisis in the Workplace
|
COVID-19
|
Download
|
|
From the NECA-IBEW Welfare Trust Fund and CVS/Caremark
|
COVID-19
|
Download
|
|
OTC COVID Test Paper Claim Form
|
COVID-19
|
Download
|
|
OTC At-Home COVID Test - Direct Coverage Information
|
COVID-19
|
Download
|
|
BCBS Class Action Settlement 2021
|
Other
|
Download
|
|
Go Green Agreement
|
Go Green
|
Download
|
|
Know Before You Go Member Flyer
|
Eye Med
|
Download
|
|
Mobile App Member Flyer
|
Eye Med
|
Download
|
|
Member Web Flyer
|
Eye Med
|
Download
|
|
Provider Locator Member Flyer
|
Eye Med
|
Download
|
|
EyeMed Reimbursement Form for Out-of-Network Claims
|
Eye Med
|
Download
|
|
Supplemental Retirement Benefit Plan Presentation
|
Retirees Information
|
Download
|
|
2022 Summary of Benefits and Coverage: Active Base Plan
|
Schedules of Benefits
|
Download
|
|
2022 Summary of Benefits and Coverage: Alt Plan
|
Schedules of Benefits
|
Download
|
|
2022 Summary of Benefits and Coverage: Alt Plan (Individual + Children)
|
Schedules of Benefits
|
Download
|
|
2022 Summary of Benefits and Coverage: Retiree Under 65 Base Plan
|
Schedules of Benefits
|
Download
|
|
Labor First Announcement
|
Labor First
|
Download
|
|
Labor First FAQs
|
Labor First
|
Download
|
|
PaydHealth Select Drugs and Product List 2023
|
PaydHealth
|
Download
|
|
IBEW NECA Conduit 401(k) Plan Trust Agreement
|
401(k) Plan
|
Download
|
|
IBEW NECA Conduit 401(k) Plan Document
|
401(k) Plan
|
Download
|
|
IBEW NECA Conduit 401(k) Summary Plan Description
|
401(k) Plan
|
Download
|
|
Rollover Into Plan Form
|
401(k) Plan
|
Download
|
|
Distribution Form
|
401(k) Plan
|
Download
|
|
Age 59.5 Distribution Form
|
401(k) Plan
|
Download
|
|
Enrollment Form
|
401(k) Plan
|
Download
|
|
Hardship Form
|
401(k) Plan
|
Download
|
|
Wellness Power Welcome Letter 2023
|
Wellness Power
|
Download
|
|
Wellness Power Biometric Form 2023
|
Wellness Power
|
Download
|