Documentation

Plumbers’ Welfare Fund, Local 130, U
.A.

Summary Plan Descriptions

Summary Material Modification Letters

Life Changing Events

Any of the following events requires Participants and/or dependents to send the proper associated documentation to the Welfare Fund office (Links Below):

Marriage

  1. Copy of Marriage certificate
  2. New Beneficiary Card
  3. Coordination of Benefits Form
Divorce or Legal Separation
  1. Copy of Divorce decree or Court Order
  2. New Beneficiary Card
Birth
  1. Copy of Child’s birth Certificate
  2. Copy of Social Security Card
  3. New Beneficiary Card
Termination of Spouse’s primary insurance
  1. Letter of Termination from Primary insurance
New employment of spouse
  1. Coordination of Benefits Form
Change of address
  1. Change of Address Form

All Forms

Coordination of Benefits Form
New Beneficiary Card
Plumbers Welfare HRA Form
Change of Address Form
All forms need to be faxed to Fax: (312) 226-7285.