Health Plan Notices, 2018 Re-Enrollment Form and 2018 Supplemental Part D Form Mailed to Health Plan Participants

Eligible Participants must return forms to the Trust Funds Office by December 31, 2018

On December 4, 2018 the Local 103, I.B.E.W. Health Benefit Plan mailed all eligible Health Plan Participants a Health Plan Notice and 2018 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 December 31, 2018.

Additionally, the 2018 Medicare Part D (Blue) Form & Notice was also mailed to all Supplemental Plan Participants (those covered under Medicare) and those who will become eligible for Medicare coverage in 2019. The Medicare Part D Form must also be completed and returned by December 31, 2018.

Failure to return completed Forms by December 31 could result in suspension or termination of coverage.

Both Health Plan forms may also be downloaded from the website by clicking these links:

2018 Annual Re-Enrollment Form
2018 Medicare Part D Form

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