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Forms and Documents

Home 9 Forms & Documents

General

Benefits at a Glance Guide
Blue Cross Blue Shield of Arizona – Machine Readable Files (MRFs) (healthsparq.com)
2025 Spring Newsletter
2025 Winter Newsletter
2024 Fall Newsletter
2024 Summer Newsletter
2024 Spring Newsletter
2024 Winter Newsletter
2023 Fall Newsletter
2023 Summer Newsletter
2023 Spring Newsletter

Health and Welfare

2024 Benefits Guide
Dental Summary – Actives
Dental Summary – Retirees
Delta Dental Certificate – Actives and Pre-Medicare Retirees
Delta Dental Certificate – Medicare Retirees
Health and Welfare Summary Plan Description – Actives and Pre-Medicare Retirees
Humana Certificate – Medicare Retirees
Medimpact Pharmacy Benefit Overview
Summary of Benefits and Coverage 2022 – Actives and Pre-Medicare Retirees
Summary of Benefits and Coverage 2022 – Retirees
VSP Benefit Summary

Pension

Pension Application Form
Pension Plan Summary Plan Description

Defined Contribution

401k employee additional contribution form
Defined Contribution Application Form
Defined Contribution Plan Summary Plan Description
Materials from Principal
Eligibility | Health and Wellness | Pension | Defined Contribution | Forms and Documents | Contacts | Apps
© 2025 IBEW Local No. 640 and Arizona Chapter NECA Health & Welfare Trust Fund | IBEW Local No. 640 and Arizona Chapter NECA Defined Benefit (Pension) Trust Fund | IBEW Local No. 640 and Arizona Chapter NECA Defined Contribution (401k) Trust Fund

The information on the website describes only some of the key features of certain benefits plans offered by the IBEW Local No. 640 and Arizona Chapter NECA Benefit Funds. Please review the plans’ Summary Plan Description (SPD) and/or official plan document, as the SPD or plan document will govern. The Fund has the right to amend or terminate the plans at any time.