The United Association of Plumbers and Pipefitters
Local Union #396 Health and Welfare Fund
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• Your Personal Information

• Summary Plan Description
  • Booklet
  • Changes to Booklet
  • Annual Notices
  • Privacy Policy
  • HIPAA Portability Rights

• Forms (All forms must be returned via mail.)
• Return of Organization Exempt from Income Tax form 990
• Beneficiary Election Form/Change of Address Form
• Disability Claim Form
• Cobra Election Form
• HIPAA Portability Rights
• Application for Early Retirement and/or Permanent Disability

• Related Links
• www.envisionrx.com

All Forms are in PDF Format. Download the FREE Adobe Acrobat Reader Here.