Form Index

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Hours Requirement for Coverage

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Hours Requirement for Coverage

Summary Benefits Coverage for Plan 1

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Summary Benefits Coverage for Plan 1

Summary Benefits Coverage for Plan 2

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Summary Benefits Coverage for Plan 2

Summary Benefits Coverage for Plan 3 (Retiree Plan)

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Summary Benefits Coverage for Plan 3 (Retiree Plan)

Alternate Address Request

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Alternate Address Request for Health Fund Correspondence

Authorization for Release of Protected Health Information

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Authorization for Release of Protected Health Information

Disability Claim Form

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Short Term Disability Claim Form

Personal Representative Form

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Personal Representative Form

Reimbursement Agreement

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Reimbursement Agreement

Reimbursement Agreement Letter

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Download the Reimbursement Agreement Letter that must be completed, signed and returned to the Carpenters Health Benefits Fund Office in Wilmington.

Transfer of Contributions

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Request Form for Transfer of Contributions to New England Carpenters Health Benefits Fund