Welcome Participants of Plumbers and Pipefitters Local Union 421 Fringe Benefit Funds!
Plumbers & Pipefitters Local 421 Fringe Benefit Funds
Contact Info
Online:
Contact Form
Email:
(
[email protected]
)
Phone:
(800-842-5899)
Fax:
(954-266-2079)
Actions
Go Green
Send a Secure File
Access My Benefits
421 Covid Relief
421 Dependent Verification
External Links
UA Local 421
MyCigna.com
Wageworks HRA Benefit
Rightway Healthcare
Optum Rx Pharmacy Benefits
Contact Us
Online:
Contact Us
Email:
[email protected]
Phone:
800-842-5899
Fax: 954-266-2079
Health Care Benefits - Forms
Accident or Injury Detail Form
Annual Verification Form
Enrollment Form
PHI Authorization Form
Subrogation Agreement
Health Care Benefits - Notices
About COBRA Continuation
CHIP Notice
Notice of Privacy Practices
Prescription Drug Credible Coverage Notice
WHCRA Notice
Health Care Benefits
Construction SBC 2019
Construction SBC 2020
Construction Summary Plan Description.(SPD) 10.2011
Creditable Coverage Notice
OptumRx Drug Formulary 2019
Retirees Over 65 SBC 2020
Service SBC 2019
Service SBC 2020
Service Summary Plan Description (SPD) 10.2011
Retiree Health Care Benefits
Non-Medicare Retiree SBC 2019
Non-Medicare Retiree SBC 2020
Over Age 65 Retiree SBC 2019
Over Age 65 Retiree SBC 2020
Retiree Summary Plan Description (SPD) 10.2011
Retirement Benefits - Forms
2020 IRS Form W4-P
DC COVID-19 Application
DC Plan Application for Retirement Benefits
DC Plan Interest Statement
DC Plan Rollover Election
DC Plan Rollover Special Tax Notice
DC Plan Spousal Waiver Form
Pension Plan Application for Retirement Benefits
Pension Plan Direct Deposit Form
Pension Plan Retiree App Instruction Letter
Retirement Benefits - Notices
Annual Funding Notice
DC COVID-19 Application
Retirement Benefits
Defined Contribution Plan Document 1.1.14
Pension Plan Summary Plan Description 2016