![]() ![]() ![]() A Representative from the General Office or the Health Benefits Department will contact you regarding your request should there be any questions. The links below lead to different fill-in request forms. Requested forms will be sent out using the Fund’s secure e. In order to receive an electronic form, you must provide the Fund office with a valid e-mail address. VSP PO Box 385018 Birmingham, AL 35238-5018 Ref # Member Information 107 lanta bus scheduleTo find out if you qualify for benefits and to request an electronic form, please call the Fund office at 21 or toll free at 80, Monday-Friday 8:30 am to 5:00 pm. VisionUFCW Local 880 9199 Market Place, Suite 2, Broadview Heights, OH 44147 21 or Toll Free 80 Member Reimbursement Form To request reimbursement, complete this form (in blue or black ink), enclose a legible copy of your itemized receipt(s), and send them to the following address. VSP PO Box 385018 Birmingham, AL 35238-5018 Ref # Member InformationBenefit Claim Forms Coughlin Medical Claim Form Coughlin Dental Claim Form Part-time Local 1400 members of Extra Foods, Superstore, Real Canadian Wholesale Club who are not covered by the company group insurance plan, and members of Garda Security and their eligible dependents. ![]() Ontario UFCW Health & Welfare Fund - Benefit Plan ApFollow-up Message From The Board Of Trustees - Response to COVID-19 On Mawe confirmed that all benefits except short and long term disability, would be extended to May 31, 2020, to those of you who have been temporarily laid off from work.Southern California United Food & Commercial Workers Unions and Food Employers Joint Benefit Funds / Eligibility & EnrollmentVSP Member Reimbursement Form To request reimbursement, complete this form (in blue or black ink), enclose a legible copy of your itemized receipt(s), and send them to the following address. This claim will be returned to you if it is incomplete or contains errors. FORM – F1 UFCW LOCAL 247 BENEFIT TRUST FUND DRUG, EXTENDED HEALTH CARE (“EHC”) & VISION EXPENSES FORM 318B – 2099 LOUGHEED HWY., PORT COQUITLAM BC V3B 1A8 Tel: 60 Toll-Free: 1-80.Box 4100 Concord, CA 94524-4100 Fax (925) 746-7549 Please call Member Services if you have any questions (800) 552-2400 Sick Leave Claim Form /Disability …UFCW NATIONAL HEALTH AND WELFARE FUND VISION SERVICES CLAIM FORM VisionServiceClaimForm.direct_reimbursement.03042021 UFCW NATIONAL HEALTH AND WELFARE FUND 66 GRAND AVENUE, ENGLEWOOD, NEW JERSEY 07631 (201) 569-8801 FAX (201) 569-1085 VISION SERVICES CLAIM FORM MEMBER PLEASE PRINT 1-5 BELOW 1.2020. ![]()
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