ONLINE FORMS
Health & Welfare
- 2022 COB-Active
- 2022 COB-Retired
- Affordable Care Act Section 1557 Notice
- Beneficiary Designation Form
- Benefit Fund Direct Deposit Form
- Change of Address Form
- Cigna Dental Benefit Summary
- Cigna Dental FAQs
- Davis Vision Benefit Summary
- Davis Vision Member FAQs
- Express Scripts Claim Form
- Express Scripts Medicare Formulary List
- Health & Welfare Federal Acts & Guidelines Notice
- HRA Claim Form
- Maiden Name Form
- Notice of COBRA Rights
- Patient First Physical Exam Authorization Form
- Spouse Employment Verification Form
- Summary of Benefits and Coverage 2022 - Class I
- Summary of Benefits and Coverage 2022 - Class II
Summary Plan Description (SPD Documents)
- Carpenters Health & Welfare Plan (May 2020)- Summary Plan Description (SPD)
- Carpenters Pension and Annuity Plan (May 2020) - Summary Plan Description (SPD)
- Carpenters Retiree Health & Welfare Coverage (Jan 2021) - Summary Plan Description (SPD)
- Carpenters Savings Plan (May 2020) - Summary Plan Description (SPD)
- Independence Administrators Benefit Booklet (Basic Coverage) (SPD)
- Independence Administrators Benefit Booklet (Full Coverage) (SPD)