Plan Documents
Make sure you understand important Plan information and forms
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Plan Documents & Amendments
Summary of Material Modifications
November 2023 – Reinstatement of Telehealth Services Retroactively to May 12, 2023
June 2023 – Clarifications to Medical Benefits Pursuant to the End of the National Emergency & Public Health Emergency
May 2023 – ABA Therapy, Speech Therapy, changes to Delta Care & Delta Dental PPO Plan Benefits
January 2023 – Change to Indemnity Medical Plan for Medicare Eligible Retirees
January 2023 – Labor First Retiree Advocate Team FAQ
October 2022 – Change to New Retiree Eligibility for Bargaining Employees
July 2022 – Hearing Aid Benefits Increased
March 2022 – Cash Bank Run-Out, Retiree Subsidy Increased, HRA Access for Retirees
June 2020 SMM – Medical Benefit Improvements
May 2020 – Eligibility for Active Employees & Treatment for COVID-19 for Anthem PPO Members
March 2020 – COVID-19 Testing Benefits Changes – Effective March 18, 2020
Dec 2019 SMM – Clarifications to Maximum Allowable Charges for Certain
Changes to WellDyneRX Formulary & New Opioid Management Program – Effective January 1, 2019
WellDyneRX 2019 Clinical Focus Formulary (English)
WellDyneRX 2019 Clinical Focus Formulary (Spanish)
Assignment Rules – Effective September 25, 2018
Changes to DC16 Health Plans & Healthy Rewards – Effective January 1, 2018