| For Participants > Downloads |
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| Health and Welfare |
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Delta Dental Claim Form (Excludes Plan B & Retirees).pdf
Delta Dental Evidence of Coverage (Excludes Plan B & Retirees).pdf
Domestic Partner Application.pdf
Domestic Partner Application (Español).pdf
Hearing Aid Claim Form.pdf
Medco Welcome Packet
Medco Prescription Drug Reimbursement Form (Indemnity Only) Medical Claim Form (Indemnity Active Carpenters Only).pdf
Notice of Creditable Coverage .pdf
Notice of Privacy Practices.pdf Orthodontic Claim Form.pdf
Physical Exam Form (Indemnity Only).pdf
Supplemental Weekly Disability Continuation Form.pdf
| Health and Welfare: Plan A and R |
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Plan Comparison.pdf
Plan Comparison (Español).pdf
Summary Plan Description - Rules & Regs - Amendments.pdf
Summary Plan Description - Rules & Regs - Amendments (Español).pdf
| Health and Welfare: Plan B and Flat Rate |
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Flat Rate Comparison.pdf
Flat Rate Comparison (Español).pdf
Plan B Comparison.pdf
Plan B Comparison (Español).pdf
Summary Plan Description - Rules & Regs - Amendments.pdf
Summary Plan Description - Rules & Regs - Amendments (Español).pdf
UnitedHealthcare Dental Provider Nomination Form (Plan B Participants Only).pdf
UnitedHealthcare Dental Provider Nomination Form (Plan B Participants Only ) (Español).pdf
UnitedHealthcare Dental List of Providers (Plan B Participants Only).pdf
| Health and Welfare: Retiree |
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Health and Welfare Self Pay Rates.pdf
Medical Claim Form (Indemnity Retirees Only).pdf
Plan Comparison.pdf
Retiree Dental Options.pdf
Retiree Dental Premiums.pdf
Summary Plan Description - Rules & Regs - Amendments.pdf
Summary Plan Description - Rules & Regs - Amendments (Español).pdf
| Pension |
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Application for Retirement.pdf
Application for Retirement (Español).pdf
Direct Deposit Election Form.pdf
IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments.pdf
Summary Plan Description - Rules & Regs - Amendments.pdf
Summary Plan Description - Rules & Regs - Amendments (Español).pdf
| Annuity |
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Application for Withdrawal.pdf
Application for Withdrawal (Español).pdf
Direct Deposit Election Form.pdf
IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments.pdf
Self Direct Annuity Class List.pdf
Summary Plan Description - Rules & Regs.pdf
Summary Plan Description - Rules & Regs (Español) .pdf
| Vacation |
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Early Withdrawal Application.pdf
Early Withdrawal Application (Español).pdf
Summary Plan Description - Rules & Regs - Amendments.pdf
Summary Plan Description - Rules & Regs - Amendments (Español).pdf
| General |
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Address Change Form.pdf
Address Change Form (Español).pdf Disability Packet.pdf
Disability Packet (Español).pdf
Enrollment Form.pdf
Enrollment Form (Español).pdf
Notice of Privacy Practices.pdf
Obtaining a HIPAA Privacy Notice & Women's Health & Cancer Rights.pdf
Protected Health Information Authorization Form.pdf
Protected Health Information Authorization Form (Español).pdf
2006 Summary Annual Report
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