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2019 Claim Form
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Download Form
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2019 Claim Form for Health Care Benefits |
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2020 Claim Form
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Download Form
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2020 Claim Form for Health Care Benefits |
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2021 Claim Form
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Download Form
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2021 Claim Form for Health Care Benefits |
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2022 Claim Form
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Download Form
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2022 Claim Form for Health Care Benefits |
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2023 Claim Form
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Download Form
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2023 Claim Form for Health Care Benefits |
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2024 Claim Form
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Download Form
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2024 Claim Form for Health Care Benefits |
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2025 Claim Form
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Download Form
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2025 Claim Form for Health Care Benefits |
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2026 Claim Form
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Download Form
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2026 Claim Form for Health Care Benefits |
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Accident Claim Form
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Download Form
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All questions must be answered. Unanswered questions may delay benefit consideration! |
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Adult Child (Age 19-26) Enrollment Form
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Download Form
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This form must be completed in full for each adult child and submitted to the Fund Office within 30 days. |
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Building & Heavy Highway Agreement 2025 - 2030
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Download Form
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HigBuilding & Heavy Highway Agreement 2025 - 2030 |
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Change of Address
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Download Form
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Please notify the fund office immediately for change of address. |
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Construction Contribution Form
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Download Form
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Construction Contribution Form |
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Enrollment Card
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Download Form
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WE REQUIRE A MARRIAGE CERTIFICATE IF YOU HAVE A DEPENDENT SPOUSE & BIRTH CERTIFICATE FOR DEPENDENT CHILDREN |
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Masonry Agreement 2025 - 2030
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Download Form
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Masonry Agreement 2025 - 2030 |
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Medical Record Release
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Download Form
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Authorization for Release of Medical Information |
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Non-Contstruction (Industrial) Contribution Form
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Download Form
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Non-Contstruction (Industrial) Contribution Form |
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Ullico Beneficiary Form
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Download Form
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Ullico Enrollment and Beneficiary Form |
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Wage Addendum (Building Wage Rate Local 703)
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Download Form
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Local 703 Building Wage Addendum |
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Wage Addendum (Building Wage Rate Local 773 & 1197)
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Download Form
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Local 773 & 1197 Building Wage Addendum |
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Wage Addendum (Heavy Hwy Utility Wage Rate Local 159 & 703)
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Download Form
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Local 159 & 703 Wage Addendum (Heavy Hwy Utility Wage Rate) |
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Wage Addendum (Heavy Hwy Utility Wage Rate Local 773 & 1197)
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Download Form
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Local 773 & 1197 Wage Addendum (Heavy Hwy Utility Wage Rate) |
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Wage Addendum (Oil and Chip Maintenance Work Wage Rate)
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Download Form
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Wage Addendum (Oil and Chip Maintenance Work Wage Rate) |