Trust Fund Forms
Claim Forms and Application Forms for health and welfare, local and international pensions and 401 contributions are provided below.
We have also provided links to Blue Shield and New York Life for your convenience.
If you would like a form mailed to you, call the United Association Local Union 230 Office or, better yet,
come to the General Membership meeting on the second Friday of the month at 7:00 p.m. and pick one up.
- Enrollment & Beneficiary Form
- Medical, Dental and Prescription Claim Form
- Health Reimbursement Arrangement (HRA)Claim Form
- Prescription Claim Form
- Change of Address Form for SCPT Trust Fund
- Change of Address Form for National Pension
- Disability Forms
- Vacation and Holiday Monthly Benefit Form
- Vacation and Holiday Interim Withdrawal Form
- Basic Pension (Local) Application
- National Pension Application
- 401 Enrollment Form
|John Hancock Retirement Plan (401 k plan)||www.mylife.jhrps.com|
|Blue Shield of California||www.blueshieldca.com|
|Southern California Pipe Trades Administrative Corporation||www.scptac.org|
|California Insurance Marketplace||www.coveredca.com|
|The Health Insurance Marketplace||www.healthcare.gov|
|Plumbers & Pipefitters National Pension Fund||www.ppnpf.org|