Health Plan Notice: 2022 Re-Enrollment Form Mailed to Health Plan Participants

Eligible Participants must return forms to the Trust Funds Office by June 30, 2022

On June 1, 2022 the Local 103, I.B.E.W. Health Benefit Plan mailed all eligible Participants a Health Plan Notice and the 2022 Re-Enrollment (Yellow) Form. These forms are required in order to ensure we have the most accurate information on file, and so the Plan can provide the best service possible for all eligible Participants and their families. To continue coverage under the Plan, eligible Participants must return the completed YELLOW Re-Enrollment Form by June 30, 2022.

Failure to return completed Forms by June 30, 2022 could result in suspension or termination of coverage.

Participants who have any questions are encouraged to call the Trust Funds Office at 617-288-5999.

Health Plan forms may also be downloaded from the website by clicking this link: 2022 Annual Re-Enrollment Form