Michigan Carpenters'

Health Care Button

Pension Button

Back Button

Participant Communications


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.

Get Acrobat Reader

  • Notice of Health Plan's Privacy Policy (HITECH) (May 2010)
  • Retirement and Minimum Coverage Self-Payment Rates (October 2006)
  • Medicare Part D Prescription Drug Coverage (November 2005)
  • Privacy of Your Protected Health Information (PHI) (April 2003)
  • Notice of Health Plan's Privacy Policy (April 2003)
  • List of Disclosures for Which Your Authorization is NOT required (PHI) (April 2003)
  • Important Notice. - Self Payment Rates
  • Important COBRA Notice Document
  • Important Notice To Active Employed Participants (April 2002)
  • Notice: Women's Health and Cancer Rights (April 2002)
  • Summary of Material Modifications:

  • 90 Day Prescription Drug - Mail Order & Retail (April 2010)
  • Changes to Fund Benefits and Eligibility Rules (September 2009)
  • Summary of Material Modifications (August 2006)
  • Summary of Material Modifications (June 2006)
  • Summary of Material Modifications (May 2006)
  • Summary of Material Modifications (June 2005)
  • Summary of Material Modifications (January 2005)
  • Summary of Material Modifications - Vision Discounts (September 2003)
  • Summary of Material Modifications (August 2003)
  • Summary of Material Modifications (May 2003)
  • Summary of Material Modifications (December 2002)
  • Summary of Material Modifications - Self Payment Rates (December 2002)
  • Back Button


    6525 Centurion Drive, Lansing, MI 48917-9275
    Phone: 517.321.7502 • Toll-free: 800.273.5739 • Fax: 517.321.7508