B&C Trust Funds

Standard Funds Documents:

Participant Enrollment Form

Participant Change of Information Form

Health Benefit Documents:

Health Benefits Agreement & Declaration of Trust

UniCare MedicareRX Rewards Evidence of Coverage Booklet

UniCare MedicareRx Rewards Formulary Booklet

State Health Insurance Assistance Program Contact Listing

W-1 Summary Plan Description and Rules & Regulations

W-Plans for Medicare-Eligible Pensioners SPD and Rules & Regulations

Retiree Enrollment Form for W-1 Benefits

P-Plan Summary Plan Description and Rules and Regulations

P-Plan - Summary of Material Modifications December 2017

P-Plan - Summary of Material Modifications December 2015

P-Plan Beneficiary Designation Form

P-Plan Claim Form

HIPAA Privacy Notice

Pension Benefit Documents:

Pension Fund Amended and Restated Rehabilitation Plan

Pension Fund Agreement & Declaration of Trust

Notice of Rehabilitation Plan Adoption

Pension Fund Rehabilitation Plan

Pension Application Form

Pension Evaluation Form

Pension Summary Plan Description and Rules & Regulations as of January 2010 (Version P-6123-10)

Pension Summary Plan Description and Rules & Regulations as of June 2013 (Version P-6123-11)

Pension Beneficiary Designation Form

Pension Direct Deposit Authorization Form

Pension Medical Examination Form

Joint and Survivor Rejection Form

Change of Address Form

Reyes Settlement Documents:

Reyes Settlement Notice

Reyes Settlement Application Form

Federal IRS Documents:

Federal IRS Form W-4P

Federal IRS Form W-9

Standard Collective Bargaining Clause Documents:

Health Benefits SCBC Daily

Health Benefits SCBC Hourly

Health Benefits SCBC Monthly

Pension SCBC Hourly

Pension SCBC Daily

Having trouble viewing this document? 

PDF (Portable Document Format) files require Adobe Reader® Click on the link to the right to get Adobe Reader® for free.