Trust Fund Forms
Claim Forms and Application Forms for health and welfare, local and international pensions and 401 contributions are provided below.
We have also provided links to Blue Shield and New York Life for your convenience.
If you would like a form mailed to you, call the United Association Local Union 230 Office or, better yet,
come to the General Membership meeting on the second Friday of the month at 7:00 p.m. and pick one up.
- Beneficiary Enrollment Form for the SCPT Trust Fund
- Enrollment Form for the SCPT Trust Fund
New Participant Overview for the SCPT Trust Fund- Annual Coordination of Benefits Form
- Injury & Third Party Liability Form
- Disenrollment for the SCPT Trust Fund
- Enrollment & Beneficiary Form for National Pension
- Delta Dental Benefit Enrollment Form
- VSP Vision Benefit Enrollment Form (Active)
- VSP Vision Benefit Enrollment Form (Pensioner)
- Health Reimbursement Arrangement (HRA) Mobile APP Guide
- Health Reimbursement Arrangement (HRA) Website Portal Guide
- Health Reimbursement Arrangement (HRA)Claim Form
- HRA Subsidized Health Pay COBRA Auto Pay Form
- Prescription Claim Form 03122020 fillable
- Change of Address Form for SCPT Trust Fund
- Change of Address Form for National Pension
- Disability Forms
- Monthly Vacation & Holiday Form
- Vacation and Holiday Interim Withdrawal Form
- Vacation and Holiday Direct Deposit
- Basic Pension (Local) Application
- National Pension Application
- 401 Enrollment Form
Important Links
| John Hancock Retirement Plan (401 k plan) | https://www.myplan.johnhancock.com/login |
| Blue Shield of California | www.blueshieldca.com |
| Southern California Pipe Trades Administrative Corporation | www.scptac.org |
| California Insurance Marketplace | www.coveredca.com |
| The Health Insurance Marketplace | www.healthcare.gov |
| United Association National Pension Fund | www.uanpf.org |
