Health

PHBP Medical and Prescription Drug Plan

Forms (5)

PHBP Coordination of Benefit Payments

PHBP Express Scripts Mail Order Form

PHBP Welfare Wage Replacement Day Form.pdf

PHBP - Enrollment Letter and Form.pdf

PHBP Benefit Application.pdf

Documents (22)

*NEW* COBRA Continuation Coverage for Dependents - Age 26

*NEW* PHBP copay increase - October 1, 2021

Summary of the COBRA Premium Assistance Provisions Under the American Rescue Plan Act of 2021

COVID-19 Deadline Extensions - COBRA and Claims Appeals

Important Information regarding Form 1095-B

COVID-19 Extended Deadline of Copay Increase w/o Physical Exam

PHBP Actives & Non-Medicare Retiree SBC 2020-2021

PHBP Medicare-Eligible Retiree SBC 2020-2021

PHBP Telehealth Coverage Notice.pdf

PHBP COVID-19 Diagnosis & Testing.pdf

Pension, Hospitalization and Benefit SPD.pdf

PHBP Plan - Certificate of Creditable Coverage.pdf

2018 PHBP Nondiscrimination.pdf

Connect to Health Newsletter

Health Advocate Brochure

Gene Therapy exclusion

Important Information Regarding Alcohol and Substance Abuse Benefits

Important Information Regarding Coverage of Compound Prescriptions

JIB Medical P.C. Information

PHBP Area Group Practices

Express Scripts Opioid Management Services

PHBP Plan Changes - July 2019.pdf

Archived PHBP Medical and Prescription Drug Plan Forms & Documents (24)

COVID-19 Deadline Extensions - COBRA & Claims Appeal.pdf

Health Plan Newsletter - April 2013

Health Plan Newsletter - February 2010

Health Plan Newsletter - October 2008

Health Plan Newsletter - October 2010

Health Plan Newsletter - September 2012

Important changes to Your Health Plan - Effective 2009

Important Changes to Your Health Plan - Effective 2011

Important Changes to Your Health Plan - Effective 2013

Important Information About Anthem Cyber Attack

Medco Opportunities Newsletter - March 2007

Medco Specialist Pharmacies Can Help You

New Improved JIB Optical Dept. Pricing

Notice of Improved Prescription Drug Coverage Effective January 1, 2010

Pension, Hospitalization and Benefit Plan 2008 Survey Results

PHBP Changes Mandated by Health Care Legislation

Summary of Benefits and Coverage - September 2012

Important Pension Plan Information for 'A' Rated Participants

Important Benefit Plan Changes

PHBP Nondiscrimination Notice

PHBP Summary of Benefits and Coverage - 2017-2018

PHBP Summary of Benefits and Coverage - 2018-2019.pdf

PHBP Summary of Benefits and Coverage - 10-1-19.pdf

Health Advocate Smoking Cessation

Employees' Security Fund Medical, Prescription Drug and Dental Plan

Forms (7)

ESF Health and Welfare Plan Claims Form

ESF Pension Direct Deposit Form

ESF Pension Tax Change Form

ESF ESI Express Scripts Mail Order Form

ESF Dental Claim Form.pdf

ESF Health and Welfare Plan Enrollment Form.pdf

ESF Health and Welfare Plan Optical Benefits Request Form.pdf

Documents (18)

ESF Summary of the COBRA Premium Assistance Provisions Under the American Rescue Plan Act of 2021

ESF COVID-19 Deadline Extensions - COBRA and Claims Appeals

ESF Plan A - Summary of Benefits and Coverage - 2021

ESF Plan C - Summary of Benefits and Coverage -2021

ESF Retiree - Summary of Benefits and Coverage - 2021

Important Information regarding Form 1095-B

Important Information for all ESF Plan 'C' Participants and eligible dependents regarding diabetic supplies

ESF Telehealth Coverage Notice.pdf

ESF Plan C - COVID-19 Diagnosis & Testing.pdf

Employees' Security Fund - Health and Welfare Plan SPD.pdf

ESF Medical Plan Certificate of Creditable Coverage.pdf

HIPPA Privacy Notice

ESF Gene Therapy exclusion

Important Changes to Your Health Plan Effective 1.1.2013

Important Information for all Plan 'C' and Plan 'A' Participants. Effective Jan 1, 2017

Important Information Regarding Coverage of Compound Prescriptions

Healthcare Advocate Brochure

ESF Nondiscrimination Notice and Taglines - 2020.pdf

Archived Employees' Security Fund Medical, Prescription Drug and Dental Plan Forms & Documents (17)

ESF - COVID-19 Deadline Extensions - COBRA and Claims Appeals

ESF Plan A - Summary of Benefits and Coverage - 2020.pdf

ESF Plan A - Summary of Benefits and Coverage - 2019.pdf

ESF Plan C - Summary of Benefits and Coverage - 2020.pdf

ESF Plan C - Summary of Benefits and Coverage - 2019.pdf

ESF Retiree - Summary of Benefits and Coverage - 2020.pdf

ESF Retiree - Summary of Benefits and Coverage - 2019.pdf

ESF Plan C - Summary of Benefits and Coverage

Plan C Participants - New Prescription Drug Annual Max and Office Visit Copay

Summary of Benefits and Coverage for Retirees

ESF- Notice on Improved Prescription Drug Coverage January 2007

ESF- Notice on Improved Prescription Drug Coverage January 2008

ESF Plan A - Summary of Benefits and Coverage

Employees' Security Fund Health and Welfare Plan SPD

2018 Summary of Benefits and Coverage for Plans A, C and Retirees and 2016 Summary Annual Report

ESF Nondiscrimination Notice - 2019.pdf

Summary Annual Report 2017 - ESF Welfare Plan.pdf

Health Reimbursement Account Plan (HRA)

Forms (1)

Claim Form - Connect Your Care.pdf

Documents (4)

NEW - HRA Payment Card Changes

HRA Plan Changes - CARES Act.pdf

HIPPA Privacy Notice

Health Reimbursement Account (HRA) Plan SPD

Archived Health Reimbursement Account Forms & Documents (1)

Important Notice Regarding HRA Benefits - October 2012

Dental Benefit Plan of the Electrical Industry

Forms (1)

Dental claim form

Documents (3)

HIPPA Privacy Notice

Dental Benefit Fund SPD.pdf

Important Changes to Benefit Plans - CBA 2019.pdf

Archived Dental Benefit Plan of the Electrical Industry Forms & Documents (1)

Reminder - Submit College Letters

Elevator Division Dental Plan

Forms (1)

Elevator Division dental claim form

Documents (2)

Dental Benefit Fund of the Elevator Industry SPD

HIPPA Privacy Notice

Archived Elevator Division Dental Plan Forms & Documents (1)

Reminder - Submit College Letters

JIB Medical

Forms (0)

Documents (0)