Forms and Notices
Documents Related to Health & Welfare Fund Forms
Our documents are in PDF. You may need to download the latest version of Adobe Reader.
Coordination of Benefits (COB)
Dependent Child Certification
DavisVision Direct Reimbursement Claim Form
Coverage Medical Retiree for Debit Direct
Member's Application for Benefits-Short Term Disability
Documents Related to Health & Welfare Fund Notices
New Health Insurance Marketplace Coverage Options and Your Health Coverage:
Questions? Contact Us!
Please note, If you are looking to apply for benefits please contact the Fund office.