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PARTICIPANT EDGE – Your new Zenith American Solutions Portal – log in to find your Annuity Balance, Pension Calculator, Health Eligibility, to order new insurance cards, work history, and health claims!

Participant Edge – Log In Instructions


 

PENSION RELATED INFORMATION / FORMS:

2021 Pension Verification


 

HEALTH INSURANCE RELATED INFORMATION / FORMS:


Summary Plan Description:

IBEW Local 236 Health & Benefit Summary Plan Description

Local 236 Pension Plan SPD 2011

IBEW Local 236 Annuity SPD 2011

 

Notice of Privacy Practices:

Notice of Privacy Practices

 

2021 Open Enrollment Changes:

The Board of Trustees for IBEW Local No. 236 Health and Benefits Fund has approved changing the medical, prescription and dental insurance carriers to Empire Blue Cross Blue Shield and is also offering a new Voluntary Vision benefit also through Empire Blue Cross Blue Shield.

Please rest assured – the plans for 2021 are built to mirror the plans in place today. The IBEW Local 236 Benefit Funds Board of Trustees are preserving your out of network options and they are now offering you access to the largest network of providers available in the country. Please click below for frequently asked questions.

 

July 2021 – Open enrollment – Instructions

Empire Blue Cross Blue Shield 2021 FAQ

2021 – Who to Call – Empire Telephone Directory

 

Open Enrollment Packet:

2021 Active Open Enrollment Packet

2021 Pensioners Open Enrollment Letter

 

Rates:

2021 Monthly Premium Rates – Active

2021 Monthly Premium Rates – Pensioner

January 2021 Contribution Rate Chart

June 2021 Contribution Rate Chart

 

Enrollment & Opt Out Forms:

2021:

2021 Opt Out – (Attestation Form) – once per year

2021 Enrollment Form & Attestation Form – for Newly Opting Out

2021 Enrollment Form – To Elect New Coverage (not to opt out)

2021 Enrollment Form (CE or CW)

Pensioners – Please contact the IBEW Local 236 Benefit Fund office for appropriate Enrollment Forms

 

Summaries of Benefits:

Medical:

Summary of Benefits – Empire Blue Cross Blue Shield – Co-Pay 2021

Summary of Benefits – Empire Blue Cross Blue Shield – High Deductible 2021

Summary of Benefits – Empire Blue Cross Blue Shield – CE & CW 2021

Dental:

Summary of Benefits – Empire Blue Cross Blue Shield – Dental

Vision:

Empire Blue Cross Blue Shield – Vision Summary of Benefits 2021

Empire Vision Safety Glasses Benefit Summary

 

Pooled Benefits:

Mutual of Omaha – Short Term Disability Benefit

Mutual of Omaha – Long Term Disability Benefits

Mutual of Omaha – How to Access Claims Online – This will show you how to view your disability status and payment information, if you have submitted a claim for disability benefits.

Mutual of Omaha – Active – Life Insurance Benefit

Mutual of Omaha – Retiree – Life Insurance Benefit

Mutual of Omaha – AD&D Benefits

 

Jaeger & Flynn Documents:

Jaeger & Flynn – Direct Deposit Flyer

Jaeger & Flynn – WEX Mobile App Communication

 

2020 & previous:

Opt Out (Attestation) Form – Once Per Year

Enrollment Form and Attestation Form – For New Opt Outs

Enrollment Form

Enrollment Form (CE or CW)

Pensioners – Please contact the IBEW Local 236 Benefit Fund office for appropriate Enrollment Forms

2020 Monthly Premium Rates

Contribution Rate Chart – January 2020

2020 Monthly Premium Rates – Active

2020 Monthly Premium Rates – Pensioner

Summary of Benefits – CDPHP Copay Plan 2020

Summary of Benefits – CDPHP High Deductible 2020

Summary of Benefits – BlueShield of NorthEastern NY Medical 2020

Summary of Benefits – BlueShield of NorthEastern NY Dental 2020

Summary of Benefits – CDPHP – for the CE or CW Class 2020

 

STATE & FEDERAL NOTICES:

CMS Disclosure Notice

Federal and NY State Health Plan Required Notices with SBCs

CECW Federal and NY State Health Plan Required Notices with SBC


 

ANNUITY RELATED INFORMATION / FORMS:


Annuity Guidelines

Annuity – Termination (Unemployment)

Annuity – In-Service (Once Per Year)

Annuity – Disability

Annuity – Education

Annuity – Normal (Retirement)

Annuity – Lump Sum Termination

Annuity – Direct Deposit Form – Sign up for direct deposit for annuity payments! You will no longer need to wait for checks to arrive in the mail!


BENEFICIARY FORMS:

Beneficiary Form * – All 3 funds (Life Insurance, Pension & Annuity)

Beneficiary Form – CW or CE * – Annuity only

**The completion and submittal of a beneficiary form does not guarantee eligibility for benefits. Please contact the IBEW Local 236 Fund Office to request status of eligibility.**