Forms And Documents

Files are in downloadable PDF format and require Adobe Reader.

Topic Form Name Description
Behind the Scenes: Winter, 2023
Health & Welfare Annual Physical and Hearing Aid Claim Form
Health & Welfare Appointment of Personal Representative
Health & Welfare ASO Dental Claim Form
Health & Welfare Anthem Blue Cross Blue Shield Claim Form
Health & Welfare CarelonRx Mail Order Form
Health & Welfare CarelonRx Reimbursement Form
Health & Welfare Combined Capp Account Request Form
Health & Welfare Credit Card Authorization Form
Health & Welfare Davis Vision Out of Network Claim Form
Health & Welfare Dental Claim Form
Health & Welfare Dependent Election Form
Health & Welfare Designation of Beneficiary
Health & Welfare Medicare Waiver Form & Instructions
Health & Welfare Missing Contribution Form
Health & Welfare Plan A to Plan C Redirection Form
Annuity Beneficiary Designation Worksheet
Annuity Deferred Salary Agreement Form 401(k)
Annuity Missing Contribution Form
Pension Direct Deposit Form
Pension Missing Contribution Form
Pension Pension Beneficiary Form
Vacation Direct Deposit Form
Vacation Missing Contribution Form
Vacation Vacation Beneficiary Form
Booklets/Documents HW Triple S SPD
Booklets/Documents IATSE HW Plan A SPD
Booklets/Documents IATSE HW Plan C SPD
Booklets/Documents IATSE Pension Plan B SPD
Booklets/Documents IATSE Pension Plan C SPD
Booklets/Documents IATSE Vacation Fund SPD
Contracts & Contributions Contribution Remittance Form
Contracts & Contributions Deferred Salary Agreement Form
Contracts & Contributions Employer Contributions and Collections Guidebook
Contracts & Contributions IANBF Home Plan
Contracts & Contributions IANBF Home Plan for Local 600 Puerto Rico Only
Contracts & Contributions IANBF Home Plan for USA829 Only
Contracts & Contributions Multi-Fund Trust Acceptance Document
Contracts & Contributions Notice - End of Year Reports - All Years
Contracts & Contributions Notice re CAPP Rate as Contribution Rate
Contracts & Contributions Participation Agreement - Annuity Deferral - 3%
Contracts & Contributions Participation Agreement - Annuity SM Deferral
Contracts & Contributions Plan A to Plan C Redirection Form
Agreement & Declarations of Trusts First Amendment Health & Welfare Declaration of Trust
Agreement & Declarations of Trusts Health & Welfare Declaration of Trust
Contracts & Contributions Multi-Fund Participation Agreement
Health & Welfare Notice to Employers Regarding Compliance with ACA
Agreement & Declarations of Trusts Annuity Fund Declaration of Trust
Agreement & Declarations of Trusts Vacation Declaration of Trust
Health & Welfare Employer Mandate ACA
Health & Welfare MetLife Disability Claim Form - Plan A Only
All Trust Acceptance Document
General Change of Address Census Card
Health & Welfare MRP IRS Updated Regulations Notice
Health & Welfare Health & Welfare Plan C Eligibility Wheel
General Company Data Sheet
Agreement & Declarations of Trusts Second Amendment Health & Welfare Declaration of Trust
Health & Welfare MetLife - Participant Life Insurance Claim Form
Annuity Annuity Fund Plan Document
Agreement & Declarations of Trusts Second Amendment - Pension Fund Declaration of Trust
Pension Pension Plan B Document
General Refund Policy and Company Data Sheet
Agreement & Declarations of Trusts Second Amendment Annuity Fund Declaration of Trust
Health & Welfare ACA Certification for MRP
Pension Pension Plan C Document
Pension Annual Funding Notice for 2013 - Pension Fund
Agreement & Declarations of Trusts Pension Fund Agreement and Declaration of Trust
Health & Welfare Davis Vision C3/C4 Discount Brochure
Annuity First Amendment - Annuity Fund Plan Document
Booklets/Documents Health & Welfare Retiree Only Medical Reimbursement SPD - 2019
Pension Annual Funding Notice for 2014 - Pension Fund
Annuity Second Amendment - Annuity Fund Plan Document
Health & Welfare MRP Claim Form
Annuity Third Amendment - Annuity Fund Plan Document
Pension Pension Estimate Request
Annuity Fourth Amendment - Annuity Fund Plan Document
Annuity Fifth Amendment - Annuity Fund Plan Document
Health & Welfare MRP Claims Direct Deposit Form
Annuity Sixth Amendment - Annuity Fund Plan Document
Pension Annual Funding Notice for 2017 - Pension Fund
Booklets/Documents IATSE Annuity Fund SPD
Contracts & Contributions Multi-Fund Trust Acceptance Document
Pension Annual Funding Notice for 2016 - Pension Fund
Pension FASB Financial Statement Disclosure for 2018
Health & Welfare Plan Updates to ABA Therapy and Disabled Dependent Children - June 2017
Health & Welfare Medical Reimbursement Program (MRP) Mileage Worksheet 2021
Health & Welfare Plan C - Medical Reimbursement Program (MRP) Reminder Notice
Health & Welfare Retiree-Only Medical Reimbursement Program (R-MRP) Annual Notice
Health & Welfare IATSE Relief Letter for Health & Welfare Participants affected by Hurricanes Harvey, Irma, or Maria
Health & Welfare HIPAA FAQs for Locals
Pension Annual Funding Notice for 2015 - Pension Fund
Health & Welfare IATSE MRP/RMRP Guidebook - 2019
Booklets/Documents HW Plan C Benefits at a Glance - 2024
General Annuity Fund Safe Harbor Notice
Annuity Seventh Amendment - Annuity Fund Plan Document
Pension Annual Funding Notice for 2018 - Pension Fund
Pension FASB Financial Statement Disclosure for 2019
Booklets/Documents IATSE Annuity Fund SPD - Spanish
Health & Welfare CAPP Rate Notice for Quarter Beginning April 1, 2023
Pension FASB Financial Statement Disclosure for 2020
Pension Annual Funding Notice for 2019 - Pension Fund
Annuity Eighth Amendment - Annuity Fund Plan Document
Annuity Ninth Amendment - Annuity Fund Plan Document
Annuity Qualified Default Investment Alternative (QDIA) Notice
Annuity How to Access and Manage Your Annuity Account
Pension Annual Funding Notice for 2020 - Pension Fund
Pension FASB Financial Statement Disclosure for 2021
Health & Welfare Medical Reimbursement Program (MRP) Mileage Worksheet_1.1.2022-6.30.2022
Health & Welfare Medical Reimbursement Program (MRP) Mileage Worksheet_7.1.2022-12.31.2022
General IRS Publication 502 - Medical and Dental Expenses for 2022 Returns
Health & Welfare Retiree Reimbursement Direct Deposit Form
Pension FASB Financial Statement Disclosure for 2022
Health & Welfare Your Rights and Protections Against Surprise Medical Bills
Health & Welfare Machine Readable Files
Booklets/Documents HW Plan A Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan C1 Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan C2 Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan C3 Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan C4 Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan MRP Summary of Benefits and Coverage - 2024
Booklets/Documents HW Plan Triple S Summary of Benefits and Coverage – English 2024
Booklets/Documents HW Plan Triple S Summary of Benefits and Coverage – Spanish 2024
Health & Welfare Travel and Lodging Claim Form
Pension Annual Funding Notice for 2021 - Pension Fund
Health & Welfare Medical Reimbursement Program (MRP) Mileage Worksheet 2023
Pension Annual Funding Notice for 2022 - Pension Fund
Pension FASB Financial Statement Disclosure for 2023