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Health and Welfare
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Forms
Performer Information Form
Change of Address Card
Medical Claim Form
Delta Dental Dental Claim Form
Merk-Medco Rx Claim Form
Attending Physicians Statement of Disability
Self-Pay Extended Coverage Program Summary
Self Pay Enrollment Form - Plan I
Self Pay Enrollment Form - Plan I Dependents
Self Pay Enrollment Form - Plan II
Self Pay Enrollment Form - Plan II Dependents
Self Pay Enrollment Form - Plan II Medical Only
Self Pay Enrollment Form - Plan II Medical Only Dependents
Self Pay Enrollment Form - Early Retirement Pensioner
Self Pay Enrollment Form - Disability Retirement Pensioner
Self Pay Enrollment Automatic Debit Form
Domestic Partner Enrollment Cover Letter
Domestic Partner Enrollment Q & A
Affidavit of Domestic Partnership
Statement of Domestic Partnership Disenrollment
Domestic Partnership Enrollment Worksheet
Affidavit of Dependency for Domestic Partnership
Performer Information Form
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Frequently Asked Questions
Health Insurance Information
Online Health Summary Plan Booklet
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Pension
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Pre-Retirement Death Benefit
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Performer Information Form
Change of Address Card
QDRO Procedure
Sample QDRO
Pension Application
Instructions Concerning Proof of Age
Pension Payment Election Form
Husband & Wife Pension Rejection
Explanation of Pension Forms
PLS Pension Distribution Rollover Election
Rollover Election Certification
Direct Rollover Instructions
Special Tax Notice re: Plan Payment
Acknowledgements and Certifications
Acknowledgements and Certifications - Disability
Infor Concerning Other Pension Plan Benefits
IRS Form w4-P
Pension Benefit Tax Withholding Election Form
Electronic Direct Deposit Forms
Retirement Declaration & Signature Card
Frequently Asked Questions
Online Pension Summary Plan Booklet
Plan Document
Retirement Links
Walk-Through Example of Pension Calculation
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Life Event Guide to Benefits
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