Documents and Forms

TitleCategoryView File
Data Card Data Card Download
Summary Plan Description for Base, Alternative, and Retiree Plans Welfare Trust Fund SPD & Plan Document Download
Summary Plan Description for Base, Alternative, and Retiree Plans - Cover Letter Welfare Trust Fund SPD & Plan Document Download
2022 Schedules of Benefits Welfare Trust Fund SPD & Plan Document Download
Welfare SPD/PD Amendment 1 Welfare Trust Fund SPD & Plan Document Download
Welfare SPD/PD Amendment 2 Welfare Trust Fund SPD & Plan Document Download
Welfare SPD/PD Amendment 3 Welfare Trust Fund SPD & Plan Document Download
Welfare SPD/PD Amendment 4 Welfare Trust Fund SPD & Plan Document Download
Welfare Trust Agreement Sept 2022 Welfare Trust Fund Documents Download
Summary Plan Description for Base, Alternative, and Retiree Plans Retiree SPD Download
Summary Plan Description for Base, Alternative, and Retiree Plans - Cover Letter Retiree SPD Download
2023 GHP Model Disclosure Notice Regarding Patient Protections Against Surprise Billing No Surprises Act Download
Request for Continuity of Care Benefits and Release of Information No Surprises Act Download
Pension Trust Fund Plan Document 2018 Pension Trust Fund SPD & Plan Document Download
Pension Trust Fund SPD 2018 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 1 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 2 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 3 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 4 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 5 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 6 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 7 Pension Trust Fund SPD & Plan Document Download
Pension Plan Document Amendment 8 Pension Trust Fund SPD & Plan Document Download
January 2023 Newsletter Current Newsletter Download
June 2022 Newsletter Archived Newsletters Download
December 2021 Newsletter Archived Newsletters Download
July 2021 Newsletter Archived Newsletters Download
December 2020 Newsletter Archived Newsletters Download
December 2019 Archived Newsletters Download
January 2019 Archived Newsletters Download
June 2019 Archived Newsletters Download
June 2018 Archived Newsletters Download
December 2017 Archived Newsletters Download
June 2017 Archived Newsletters Download
December 2016 Archived Newsletters Download
June 2016 Archived Newsletters Download
December 2015 Archived Newsletters Download
June 2015 Archived Newsletters Download
December 2014 Archived Newsletters Download
June 2014 Archived Newsletters Download
November 2013 Archived Newsletters Download
June 2013 Archived Newsletters Download
December 2012 Archived Newsletters Download
June 2012 Archived Newsletters Download
December 2011 Archived Newsletters Download
June 2011 Archived Newsletters Download
December 2010 Archived Newsletters Download
June 2010 Archived Newsletters Download
December 2009 Archived Newsletters Download
June 2009 Archived Newsletters Download
December 2008 Archived Newsletters Download
Other Liability Insurance Form Welfare Trust Fund Forms Download
Customer Service Consent (HIPAA Form) Welfare Trust Fund Forms Download
Spousal and Dependent Insurance Form Welfare Trust Fund Forms Download
Special Dependent Enrollment Form Welfare Trust Fund Forms Download
Specific Information Release Welfare Trust Fund Forms Download
Beneficiary Designation Form - Welfare Trust Fund Welfare Trust Fund Forms Download
Direct Transfer Form Welfare Trust Fund Forms Download
Hours Transfer Form Welfare Trust Fund Forms Download
Contribution Rate effective June 1, 2017 Welfare Trust Fund Documents Download
Epic Hearing Service Plan Welfare Trust Fund Documents Download
Privacy Policy Welfare Trust Fund Documents Download
EPIC Hearing Healthcare Welfare Trust Fund Documents Download
COBRA Notice Base Plan COBRA Download
COBRA Notice Alt Plan COBRA Download
COBRA Notice Single Alt Plan COBRA Download
Notification of Qualifying Event COBRA Download
Member Accident Form Accident Forms Download
Subrogation Agreement and Loan Agreement Accident Forms Download
Spouse Accident Form Accident Forms Download
Dependent Accident Form Accident Forms Download
Physician's Statement for Loss of Time from Work Accident Forms Download
HRA Benny Card Participant Guide HRA Documents Download
How to Use Your Benny Card HRA Documents Download
How to Use the HRA Mobile App HRA Documents Download
Benny Card Terms & Conditions HRA Documents Download
How to Login to the HRA Participant Portal HRA Documents Download
HRA Eligible Expenses HRA Documents Download
HRA Participant Portal User Guide HRA Documents Download
HRA Reimbursement Terms & Conditions HRA Documents Download
Use the Mobile App to Change Your Password HRA Documents Download
View HRA Account Activity HRA Documents Download
2020 Publication 502 HRA Forms Download
Direct Transfer Form HRA Forms Download
Health Reimbursement Arrangement (HRA) Account Claim for Reimbursement HRA Forms Download
HRA Direct Deposit Form HRA Forms Download
Application for Retiree Plan Retirees Forms Download
Authorization for Automatic Deposits Retirees Forms Download
Request Automatic HRA Reimbursement of Retiree Premium Retirees Forms Download
Retiree Opt-In/Opt-Out Form Retirees Forms Download
Retiree Dental and Vision Letter Retirees Forms Download
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
Complete Pension Benefit Application – Married Pension Trust Fund Forms Download
Application: Benefit Application and Certification Pension Trust Fund Forms Download
Application: Pension Application Only Pension Trust Fund Forms Download
Advanced Determination Pension Trust Fund Forms Download
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
How To Read Your EOB Explanation of Benefits Download
How to View Your eEOB Other Download
BCBS Blue Access for Members Other Download
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
Working Owner Alumni Agreement Welfare Trust Fund - Employer Information Download
Non Construction BU Agreement Welfare Trust Fund - Employer Information Download
Waiver of Non-Bargaining Participation Welfare Trust Fund - Employer Information Download
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