Boilermakers health and welfare forms

ANU - Annuity Beneficiary Form 10.2019

ANU - Determination Letter from IRS 021116

ANU - Notice of Military Service Credit (USERRA)

ANU - Plan Document effective 013015 and Amendments updated 06122024

ANU - Summary Annual Report 2018 (published 2019)

ANU - Summary Annual Report 2019 (published 2020)

ANU - Summary Annual Report 2020 (published 2021)

ANU - Summary Annual Report 2021 (published 2022)

ANU - Summary Annual Report 2022 (published 2023)

ANU - Summary Plan Description (effective 07012019) and Plan changes thru 12012021

ANU - Trust Agreement Restated 2023

EC - 10 - Frequently Asked Questions in Payroll Audit Revised 20230105

EC - 14 - Contribution Due Date Notice (Published 201402)

EC - 3 - ACH Holding Account Information 202301

EC - 4 - Employer Information Request Form 20240613

EC - 7 - Alumni Agreement Important Information Notice (Published 201709)

EC - 8 - BNF Alumni Agreement final 1.2023 - rev 7.18.23

EC - 9 - BNF Alumni Election Change Form final 1.2023 - revised 3.3.23 - fillable

EC - ANU - Summary Annual Report 2019 (published 2020)

EC - ANU - Summary Annual Report 2020 (published 2021)

EC - ANU - Summary Annual Report 2021 (published 2022)

EC - ANU - Summary Annual Report 2022 (published 2023)

EC - ANU - Summary Plan Description (effective 07012019) and Plan changes thru 07012020

EC - ANU - Trust Agreement Restated 2023

EC - HW - Trust Agreement Restated 2022

EC - HW - Trust Agreement Restated 2022 Amendment #1

EC - PEN - 14th Pension Plan Restatement effective 06012022 and Amendments 06142022

EC - PEN - 2019 FASB Disclosures 202011

EC - PEN - 2019 Rehabilitation Plan

EC - PEN - 2020 FASB Disclosures 202111

EC - PEN - 2020 Funding Improvement Plan

EC - PEN - 2021 FASB Disclosures 202211

EC - PEN - 2022 FASB Disclosures 202311

EC - PEN - 2023 Rehabilitation Plan

EC - PEN - 5500 Summary Notice 104(d) 2019 (published November 2020)

EC - PEN - 5500 Summary Notice 104(d) 2020 (published November 2021)

EC - PEN - 5500 Summary Notice 104(d) 2021 (published November 2022)

EC - PEN - 5500 Summary Notice 104(d) 2022 (published November 2023)

EC - PEN - Notice of Annual Funding 2019 (published April 2020)

EC - PEN - Notice of Annual Funding 2020 (published April 2021)

EC - PEN - Notice of Annual Funding 2021 (published April 2022)

EC - PEN - Notice of Annual Funding 2022 (published April 2023)

EC - PEN - Notice of Plan Status 2019

EC - PEN - Notice of Plan Status 2020

EC - PEN - Notice of Plan Status 2021

EC - PEN - Notice of Plan Status 2023

EC - PEN - Summary Plan Description effective 6.1.2022

EC - PEN - Trust Agreement Restated 2023

EC - PEN - Withdrawal Liability Valuation as of 123121

EC - PEN - Withdrawal Liability Valuation as of 123122

HW - 01.01.2024 Summary of Benefits and Coverage Active Coverage

HW - 01.01.2024 Summary of Benefits and Coverage Retiree Coverage

HW - 07.01.2024 Summary of Benefits and Coverage Active Coverage

HW - 07.01.2024 Summary of Benefits and Coverage Retiree Coverage

HW - 2022 Summary Annual Report (Published 2023)

HW - 2023 Summary Plan Description SPD with Amendments 1-4

HW - 2024 Annual Care Checklist

HW - 2024 ESI National Preferred Formulary Drug List

HW - 2024 United Healthcare Annual Notice of Changes

HW - 2024 United Healthcare Benefit Plan Guide

HW - Appointment of Authorized Representative Form (Jan 2023)

HW - Authorization to Release Protected Health Information (Jan 2023)

HW - BNF Vision Claim Form (Jan 2024)

HW - COB and Information Verification Form July 2024

HW - COBRA Continuation Coverage Election or Rejection Form (Jan 2023)

HW - Children's Health Insurance Program CHIP 2023

HW - Dependent Child Enrollment Form (Jan 2023)

HW - Designation of Beneficiary Card (Jan 2023)

HW - Disclaimer of Benefits Form (Jan 2023)

HW - Disclosure Notice No Surprise Billing

HW - Express Scripts Prescription Drug Claim Form

HW - M Coverage Enrollment Form (Jan 2024)

HW - M Coverage Open Enrollment Packet for 2024

HW - New York Life Long-Term Disability Information

HW - Notice of Creditable Prescription Drug Coverage 2023

HW - Privacy Practices 2023

HW - Retiree Application Form (Jan 2023)

HW - Summary of Benefits and Coverage Uniform Glossary

HW - Things to Consider Before Retirement 2023

HW - Trust Agreement Restated 2022

HW - Trust Agreement Restated 2022 Amendment #1

HW - Womens Health and Cancer Rights Act WHCRA 2023

PEN - 14th Pension Plan Restatement effective 06012022 and Amendments 06112024

PEN - 2018 Pension Funding Improvement Plan

PEN - 2019 Rehabilitation Plan

PEN - 2020 Funding Improvement Plan

PEN - 2023 Rehabilitation Plan

PEN - 21st SRWR Local Labor Shortage List 09132023

PEN - Application Instructions revised (Jan 2023)

PEN - Application Timeline (Jan 2023)

PEN - Determination Letter from IRS 110615

PEN - Notice of Annual Funding 2019 (published April 2020)

PEN - Notice of Annual Funding 2020 (published April 2021)

PEN - Notice of Annual Funding 2021 (published April 2022)

PEN - Notice of Annual Funding 2022 (published April 2023)

PEN - Notice of Annual Funding 2023 (Published April 2024)

PEN - Notice of Plan Status 2019

PEN - Notice of Plan Status 2020

PEN - Notice of Plan Status 2021

PEN - Notice of Plan Status 2023

PEN - Notice of Plan Status 2024

PEN - Pension Benefit Factor Chart Effective 100117 for Grandfathered Status Final

PEN - Pension Benefit Factor Chart Effective 5.1.2019 for Non grandfathered

PEN - Special Retiree Work Rule Request Form

PEN - Summary Plan Description effective 6.1.2022

PEN - Trust Agreement Restated 2023

PEN - W-4P Tax Form (US only) (2024)