E-Forms

Welcome to the Employee Benefit Funds secure electronic forms submission page.  For your convenience, the links below will allow you to securely submit forms and documents for processing by our team members.

When completing our electronic forms, please ensure that all required fields are filled out, and all necessary documents are attached. Please note that you will receive an automated response from our electronic forms system once your submission has been processed by one of our team members.

 

To enroll yourself and/or your eligible dependents into the Health Benefits Fund, please use this form.

Health Benefits Enrollment Form

 

If you are a currently enrolled member looking to update your Life Insurance beneficiaries, please use this form

Life Insurance Beneficiary Form

 

If you are currently enrolled, and looking to change your address or personal information, please use this form.

Change of Address/Personal Information Form

 

To submit an Eye Care Reimbursement Claim, please use this form.

Eye Care Reimbursement Form

 

If you need to send us a document, and are not required to fill out one of the forms above, please use this form.

Document Uploader