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General Forms
Change of Address - Form to notify the Fund office if you change your mailing address.
Enrollment Form - Form for enrolling for benefits.
Enrollment Form for Municipalities - Form for enrolling for benefits. This is for Municipal Employees Only.
HIPAA Privacy Notice - Notice regarding the Health Insurance Portability and Accountability Act 0f 1996.
HIPAA Authorization Form - Form to release personal information to a third party.
Health Forms
Eligibility Rules - Rules for Health Fund Benefits.
Request for Academic Certification - Form to be submitted for verification of student enrollment.
Spouse Employer Form - Form to be submitted for verification of spouse's benefits.
Dental Claim Form - Statement of Claim or Pre-Treatment Estimate Form.
Pension Forms
Application Rules - Information about applying for a pension.
Application Checklist - Make sure you have satisfied this checklist before submitting your application.
Electronic Funds Transfer (EFT) Form - Form to have your benefit transferred automatically to your bank account.
Re-Employment Request Form - Form to use if you intend to work after retirement in any capacity. Please see also Re-Employment Rules Summary below.
Re-Employment Rules Summary - Information about returning to work after retirement.
Request for Resumption of Benefits - Form to use if your benefit has been suspended for violation of the Re-Employment Rules.
Summary Plan Description - January 1, 2007 Summary Plan Description
PLEASE NOTE: This is a 9 MB file - Dial-up connections will be slow!!!
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