Forms / Notices
- Summary of Benefits and Coverage – Effective 1/1/2021 – 12/31/2021.
- Change of Address Form – Use this form to change your address. Be sure to fill it out completely and return it to the Trust Office.
- Disability Credit Acknowledgement – Use this form to acknowledge “Disability Credit” responsibilities and limitations.
- Physician’s Disability Certification – A participant’s physician must use this form to certify a participant’s disability.
More specific forms can be found on their own pages. See Pages under Forms / Notices, below, for details.