06/01/04 - Changing Your Information New guidelines established by
the Privacy Practices of the
Health Insurance Portability
and Accountability Act
(HIPAA) require that you (the
participant) notify the Trust
Office, in writing, of the
following changes. Your
signature is also required:
Change of Address Notice
- Addresses.
- Telephone number(s).
Enrollment Card
- Name.
- Social Security number.
- Date of birth.
- Beneficiary information.
- New dependent
information.
If any of this information needs
to be updated, please contact
the Trust Office. We will
provide you with the necessary form. We appreciate your help
and understanding with these
new guidelines.■
It is very important for you to
keep your address and
enrollment information up-todate.
Please let us know any
time you move or experience
any other change in enrollment.
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