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Privacy Policy

Privacy Policy

Teamsters Health & Welfare and Pension funds of philadelphia and vicinity

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Teamsters Health & Welfare and Pension funds of philadelphia and vicinity

  • Home
  • About Us
    • History of Funds
    • Fund Trustees
    • Key Fund Personnel
    • Participating Locals
    • Employer List
  • Health
    • Medical
    • Pharmacy
    • Dental
    • Vision
    • Health Documents
    • Health Forms Gallery
  • Pension
    • Pension Overview
    • Pension Documents
    • Pension FAQs
    • Pension Forms Gallery
  • Add-On Benefits
  • Resources
    • FAQs
    • Helpful Links
    • Videos
  • Unions/Employers
  • COBRA
  • Member Login
  • Newsletters
Health Forms GalleryTori2026-01-05T17:48:02+00:00

Forms Gallery

Medical & Pharmacy

Beneficiary and Census Form
Formulario para Beneficiarios y Tarjeta Censal
COB Declaration of Health Coverage
Formulario para Declaración de Cobertura de Salud del Cónyuge
HIPPA Authorization
Formulario para Autorización de HIPPA
Change of Address
Formulario para Cambio de Dirección

Dental & Vision

Dental Claim Form

Disability

Weekly Disability Claim Form
Weekly Disability Continuation Form
Application for Handicapped Coverage

CONTACT US

Call: 800-523-2846

(Toll Free) 856-382-2400

Fax: 856-382-2401

Send us a message

LOCATION

Kevon Office Center

2500 McClellan Ave, Suite 140

Pennsauken New Jersey 08109

HOURS OF OPERATION

Mon, Tue, Thu, Fri: 8:30 AM to 4:00 PM

Wed: 8:30 AM to 5:00 PM

Office Closed Mon – Fri: 12:30 PM to 1:00 PM

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