SIGN UP FOR THE NEWSLETTER
  • Black Facebook Icon
  • Home

    • Contact Us
    • Member Forms
    • Member Resources
  • Member Portal

  • Health & Welfare

  • Defined Benefit

  • Defined Contribution

  • Sub Fund

  • More...

    Use tab to navigate through the menu items.

    MEMBER FORMS

    MEMBER PORTAL
     

    HEALTH & WELFARE

    SUB

    Claim Form

    Dependent Coverage Election

    HRA Auto Payment

    HRA Claim Form

    HRA Direct Deposit Form

    HIPAA Authorization Form

    Loss of Time Application
    Loss of Time Direct Deposit

    Loss of Time Tax Form

    Opt Out Form – Medicare

    Opt Out Form - Dependent

    Participant Enrollment Form

    Subrogation Agreement

    Working Spouse

    Working Spouse Verification Form

    SUB Application

    SUB Direct Deposit

    Flexible Payment Planning
     

    DEFINED BENEFIT

    DEFINED CONTRIBUTION

    Credit Union Deduction

    Pension Direct Deposit

    Retiree Return to Work

    Tax Withholding

    DC to DB

    MISCELLANEOUS

    Beneficiary

    Change of Address

    Direct Deposit Form

    • Grey Twitter Icon
    • Grey Facebook Icon

    © 2017 ELECTRICAL WORKERS BENEFIT TRUST FUND, IBEW 481 EWBTF | INDIANAPOLIS, IN