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Eastern Atlantic States Carpenters Benefit Funds

Annual Funding Notice (Pension & Annuity)

  1. EAS Pension Fund - Plan Year Ending December 31, 2023
  2. EAS Pension Fund - Plan Year Ending December 31, 2024

Health & Welfare

  1. 2023 Coordination of Benefits
  2. Affordable Care Act Section 1557 Notice
  3. Beneficiary Designation Form
  4. Benefit Fund Direct Deposit Form
  5. Change of Address Form
  6. Cigna Dental Benefit Summary
  7. Cigna Dental FAQs
  8. Davis Vision Benefit Summary
  9. Davis Vision Member FAQs
  10. Davis Vision Reimbursement Claim Form
  11. Express Scripts Claim Form
  12. Health & Welfare Federal Acts & Guidelines Notice
  13. HRA Claim Form
  14. Maiden Name Form
  15. Notice of COBRA Rights
  16. Patient First Physical Exam Authorization Form
  17. Spouse Employment Verification Form
  18. Summary of Benefits and Coverage 2025 - Gold
  19. Summary of Benefits and Coverage 2025 - Silver

HIPAA

  1. Notice of Privacy Practices

Hours Department

  1. Benefit Fund Direct Deposit Form
  2. Change of Address Form
  3. Reciprocal Form

Medicare

  1. Blue Medicare Advantage Plan - Evidence of Coverage_Former NCF (2025)
  2. Blue Medicare Advantage Plan - Evidence of Coverage_Legacy CBF (2025)
  3. Express Scripts Medicare Formulary List

Merger

  1. CBF Participant Merger Notification

Retirement Funds

  1. Beneficiary Designation Form
  2. Benefit Fund Direct Deposit Form
  3. Change of Address Form
  4. Tax Form for Monthly Pension (W-4)

Summary Annual Report (SAR)

  1. EASC Annuity Fund (Plan Year Ending 12.31.2023)
  2. EASC Health Fund (Plan Year Ending 12.31.2023)

Summary of Material Modification (SMM) - EAS Carpenters Health Fund

  1. Omada_HCSC_Ivy_Disability (June 2024)

Summary Plan Description (SPD Documents)

  1. EAS Carpenters Annuity Fund SPD (Jan 2023)
  2. EAS Carpenters Health SPD - Active (Jan 2024)
  3. EAS Carpenters Health SPD - Retiree (Jan 2024)
  4. EAS Carpenters Pension Fund SPD (Jan 2023)
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