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  • Forms & Documents
  • About Us

Forms & Documents

Sound Health & Wellness Trust Sites > Retiree > Forms & Documents
  • Forms & Documents
    • Document Library

Welcome to the Document Library. Here you’ll find forms, notices and up-to-date documents regarding your benefits.

Plan Booklets and Summaries
  • Retiree Summary Plan Description Booklet (including 1-1-11 plan changes)
  • Retiree Medical Plan Changes Dated 11-8-2013
Forms
  • Third Party Liability Questionnaire
  • Third Party Liability Reimbursement Agreement
  • Medical claim form
  • HIPAA release form
Policies
  • Applied Behavior Health Analysis (ABA) Coverage Policy
  • Gender Dysphoria Policy effective 06 01 2015
  • Weight Loss Surgery Policy
  • Prophylactic Mastectomy and BRCA Testing Policy
  • Procedures for Filing Claims and Appeals
  • Physical Therapy Rehab Benefit Information—Retiree Plan
Other Plan Documents
  • Notice of Privacy Practices Revised February 2016 (Retirees)
  • Summary Annual Report – Sound Health & Wellness Retiree Trust

Questions?
Call the Trust office at
(206) 282-4500
or (800) 225-7620.

  • Forms & Documents
    • Document Library

Email Customer Service & Claims
Email Eligibility & COBRA

(206) 282-4500 or (800) 225-7620
Hours: Monday – Friday, 8:00am to 5:00pm

11724 NE 195th St. Suite 300
Bothell, WA 98011–3145

The Sound Health & Wellness Trust is a Taft-Hartley trust managed jointly by unions and employers and providing benefits to more than 51,000 participants.

Participating unions include: UFCW Local 3000, Teamsters Local 38, and UFCW Local 367.

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