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NECA/IBEW 145
Benefit Plans

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    • Procedures for Self Payments
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      • MD Form 2021
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    • Delta Dental
      • Delta Dental Provider Look Up
      • Delta Dental – PPE Update
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      • MDLIVE Video
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      • NECA-Local-No.-145-IBEW-Welfare-Plan-Prescription-Drug-Benefit Summary
      • How To Register On Website
      • How To Enroll In Mail Order
    • Medical Advocate Program (MAP)
    • Merrill Lynch
      • Local Merrill Lynch Website
    • TruHearing (VSP)
    • Vision Service Plan (VSP)
      • (VSP) Vision Benefits Summary
      • VSP – Featured Frames Listing
      • VSP – Additional Savings Coupon – 2021
      • (VSP) Out Of Network Form
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Member Dashboard
  • COVID19
  • Annuity & Profit Sharing Plan
    • Board of Trustees
    • Amendments
    • Applying for a Withdrawal
    • Fee Disclosure
    • Forms
    • Investment Changes
    • Plan Document
    • QDIA Yearly Notice
    • Special Tax Notice
    • Summary Annual Reports (SAR)
    • Summary Plan Description (SPD)
    • FAQ
  • Pension Plan
    • Board of Trustees
    • Amendments
    • Annual Funding Notice
    • Annual Pension Letter
    • Forms
    • Plan Document
    • QDRO Procedures
    • Summary Plan Description (SPD)
    • FAQ
  • Welfare Plan
    • Board of Trustees
    • Annual Notifications
    • Forms
    • Health & Welfare Statement
    • Life Insurance Certificate
    • Notice of Privacy Practices
    • Plan Document/Summary Plan Description
    • Procedures for Self Payments
    • Quarterly Fringe Statement
    • Retiree and COBRA Premium Rates
    • Summary Annual Reports (SAR)
    • Summary of Benefits & Coverage (SBC)
    • Welfare Amendments
    • Welfare FAQ
  • I-Site EOBs
  • Forms
  • News
  • Service Providers
    • BCBS Provider Lookup
    • Coaching by Hines
      • MD Form 2021
    • Consociate
      • HRA Reimbursement Form
      • Mobile App Video
      • How to Use HRA
    • Delta Dental
      • Delta Dental Provider Look Up
      • Delta Dental – PPE Update
    • Employee Assistance Program (EAP)
    • Humana
    • MDLIVE Virtual Visits
      • MDLIVE Video
    • MedOne Rx
      • NECA-Local-No.-145-IBEW-Welfare-Plan-Prescription-Drug-Benefit Summary
      • How To Register On Website
      • How To Enroll In Mail Order
    • Medical Advocate Program (MAP)
    • Merrill Lynch
      • Local Merrill Lynch Website
    • TruHearing (VSP)
    • Vision Service Plan (VSP)
      • (VSP) Vision Benefits Summary
      • VSP – Featured Frames Listing
      • VSP – Additional Savings Coupon – 2021
      • (VSP) Out Of Network Form
  • Trustee Portal

Forms

ACH Request Form for Short Term Disability

Allocation of Reciprocal Contributions

Change of Address Form

Dependent Consent Form

Disability Form

HIPAA Form

How to Access Verification Only 2021 via the Member Dashboard

MD 2021 Form

Opt-Out EOB Form

Participant Consent Form

Self-Contribution Reimbursement Form

VSP Out-Of-Network Reimbursement Form

2021 1st Time User Instructions for Health Risk Assessment

2021 Returning User Instructions for Health Risk Assessment

1700 52nd Avenue
Suite B
Moline, Illinois 61265
Phone – (309) 764-8080
Fax – (309) 764-3438

Office Hours
Monday – Thursday
8:00 a.m. – 5:00 p.m.
Friday
8:00 a.m. – 4:30 p.m.

  • Annuity & Profit Sharing Plan
  • Pension Plan
  • Welfare Plan
  • I-Site EOBs
  • Forms
  • News
  • Service Providers
  • Trustee Portal
  • Benefits Office
  • ADA Statement
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