Funds
Health & Welfare Documents
This exhibit summarizes the major provisions of the Health and Welfare Plan. It is not intended to be, nor should it be interpreted as, a complete statement of all plan provisions.
Please note that the information presented is subject to change. Contact the Fund Office for verification of current benefits.
To view your claims, eligibility, beneficiaries, and more on ISITE, click here.
Health and Welfare Downloads
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Accident Form
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Address Change Form
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Beneficiary Designation Form - Welfare
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Employment and Insurance Verification Form
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HIPAA Authorization Form
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Non PPO Employee Statement
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Loss of Time Application (Non Work Related 2024)
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Loss of Time Benefit Application (Workers Compensation)
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Privacy Notice SMART 265 Health and Welfare
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Request a Certificate of Group Coverage
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Retiree HRA Reimbursement Form
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Retiree Self Pay Rates
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SMART 265 H&W Summary Plan Description (SPD) 2022
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SMART 265 HRA Plan Document
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Subrogation Forms
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Summary Annual Report
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Trustees
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Welfare Fund Appeal Request Form
Related Links
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Union Wellness Centers
https://unionwellnesscenters.comFor additional information about FREE benefits available at the Union Wellness Centers click here.
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Union Eyes Vision Care
https://unioneyes.comFor additional information about FREE benefits available at the Union Eyes centers, click here.
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EyeMed Vision Care
http://www.eyemed.com/ -
Delta Dental
https://www.deltadentalil.comTo Locate In Network Dental Care search under either the PPO or Premier networks.
For additional information on Dental benefits click here.For Dates of Service after 10/1/2022 file claims directly to Delta Dental:
P O Box 5402
Lisle, IL 60532
Customer Service: 800-323-1743 -
TruHearing
http://TruHearing.com/SMART265/Read more about your hearing benefits with TruHearing here.
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Member Assistance Program
https://allonehealth.com/ers-eapFor additional information on Member Assistance benefits and portal click here.