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Participant Communications |
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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.
Working Spouse Annual Certification (September 2011)
Medicare Part D Creditable Coverage Certificate
Continuation of Group Health Care Coverage (COBRA)
Mail Order Prescription Drug Program Frequently Asked Questions
Summary of Material Modifications:
Benefit and Self-Pay Rate Changes (June 2011)
Medicaid and Children's Health Insurance Program (CHIP) (September 2010)
CHIP - States List (September 2010)
Notice of Privacy Practices (September 2010)
Supplemental Benefit Account (SBA) (January 2005)
Michiana Area Electrical Workers Benefits Web Site
6525 Centurion Drive, Lansing, MI 48917-9275
Phone 877.244.9473 • Fax 517.321.7508
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