Name
Type
Size
Name: Local 409 Summary of Benefits and Coverage
Type: -
Size: -
Name: Eligibility Guidelines
Type: pdf
Size: 172 KB
Name: l409 Active Updated 2021
Type: pdf
Size: 330 KB
Name: Plan A
Type: pdf
Size: 110 KB
Name: Rx Benefit for Plan A
Type: pdf
Size: 115 KB
Name: Plan B
Type: pdf
Size: 230 KB
Name: Rx Benefit for Plan B
Type: pdf
Size: 116 KB
Name: Plan C
Type: pdf
Size: 231 KB
Name: Rx Benefit for Plan C
Type: pdf
Size: 115 KB
Name: Plan D
Type: pdf
Size: 231 KB
Name: Rx Benefit for Plan D
Type: pdf
Size: 115 KB
Name: Adobe Sign Instructions
Type: pdf
Size: 357 KB
Name: Second Form of Documentation
Type: pdf
Size: 156 KB
Name: FSA Brochure 2021
Type: pdf
Size: 7.99 MB
Name: FSA Online Enrollment Instructions
Type: pdf
Size: 326 KB
Name: FSA Brochure 2023_2 Account_digital version
Type: pdf
Size: 2.95 MB
Name: Salary Reduction Agreement Form
Type: pdf
Size: 996 KB
Name: Acceptable Documentation for Dependents
Type: pdf
Size: 72.6 KB
Name: EXEMPT Active 2019 Table
Type: pdf
Size: 277 KB
Name: Plan A
Type: pdf
Size: 58.7 KB
Name: Plan B
Type: pdf
Size: 67.4 KB
Name: Plan C
Type: pdf
Size: 67.5 KB
Name: Plan D
Type: pdf
Size: 68.3 KB