Claim Forms
- 2024 Participant Information & Coordination of Benefits Questionnaire – Before any 2024 claims can be processed, you must complete this form and return it to the Trust Office.
- Medical Claim Form – Use this form to submit claims for Medical Care. Be sure to fill it out completely and return it to the Trust Office.
- Subrogation Questionnaire – Use this form to help the Trust Fund determine eligibility for health claims.
- Subrogation and Assignment of Benefits Form – This form is used by the Trust Fund to pay health claims when a third party is ultimately liable for expenses.