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Participant Communications |
Please Note: In order to view and print the following forms, you must have the Adobe Acrobat Reader installed on your computer. If you
do not have the Adobe Acrobat Reader Software and wish to download it, you may do so by clicking on the image below.
Medicare Part D Prescription Drug Coverage (2006)
Privacy of Your Protected Health Information (PHI) (April 2003)
Notice of Health Plan's Privacy Policy (April 2003)
List of Disclosures for Which Your Authorization is NOT required (PHI) (April 2003)
Important Notice About Continuation Of Your Group Health Care Coverage
Summary of Material Modifications:
Summary of Material Modifications (December 2003)
Summary of Material Modifications (May 2005)
Summary of Material Modifications (September 2005)
Summary of Material Modifications (October 2006 - Case Management and Utilization Review Services)
Summary of Material Modifications (October 2006 - Health Care for Surviving Spouses)
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