Coordination of Benefits Form

The Annual Enrollment/COB Form is sent every year to all Eligible Participants to ensure that the Fund has the most accurate information regarding your census, dependent/family information, and other coverage (employer sponsored, state sponsored) coverage to coordinate claims.

Submit your 2023 Coordination of Benefits Form online by November 1, 2023 for a chance to win one of ten $100 Visa Gift Cards!

Coordination of Benefits FAQs

Want to Know More About Your Benefits?

Find out what's covered under the Fund's extensive Benefit Plan.