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Fund Office Hours: Monday-Friday 8:00am-4:30pm

 

Fund Office Holiday Schedule

Month Event Additional Notes
January 1 New Year’s Day (office closed) +Business day before, office closes at 2:30
May (The Last Monday) Memorial Day (office closed) +Business day before, office closes at 2:30
July 4 Independence Day (office closed) +Business day before, office closes at 2:30
September (The First Monday) Labor Day (office closed) +Business day before, office closes at 2:30
November (The Last Thursday) Thanksgiving Day (office closed) +Business day before, office closes at 2:30
November (The Last Friday) Black Friday (office closed)
December 25 Christmas Day (office closed) +Business day before, office closes at 2:30

 

HEALTH INSURANCE RELATED INFORMATION / FORMS:


Summary Plan Description:

 

IBEW Local 236 Health & Benefit Summary Plan Description

 

Rates:

Contribution Rate Chart – January 2019

2019 Monthly Premium Rates – Active

2019 Monthly Premium Rates – Pensioner

 

Enrollment & Opt Out Forms:

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


 

Summaries of Benefits:

Summary of Benefits – CDPHP Copay Plan 2019

Summary of Benefits – CDPHP – HIGH DEDUCTIBLE 2019

Summary of Benefits – BlueShield of NorthEastern NY 2019

Summary of Benefits – BlueShield of NorthEastern NY Dental 2019

Summary of Benefits – CDPHP for the CE or CW Class 2019


 

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


BENEFICIARY INFORMATION: Beneficiary Forms are only acceptable in their original / unaltered state.  Copies of Beneficiary Forms are not acceptable. Please contact the IBEW Local 236 Benefit Fund office to be mailed a form.