Health and Welfare Fund Forms

Enrollment Form

Standard Medical

Accident Form & Instructions

Dependent Insurance Verification

Disability Form

Disability Direct Deposit Form

Family Medical Leave and Bereavement Benefit

Payment Election Form for Health & Welfare FMLA Benefits

Health & Welfare Special Fund Payment Request Form & Instructions

Health & Welfare Special Fund Direct Deposit Form

Physical Form

Multi-Fund Forms

Change of Address

Beneficiary Designation Form

• The Beneficiary Designation form is tied to both the Health and Welfare as well as the Pension Fund.  You must complete both sections in order to update regardless of if you are only updating the beneficiary for one of the funds.