May 9, 2008
  Forms
   
   
Accident Letter
   
Beneficiary Designation Form
   
   
COBRA Election Form
   
Dependency Questionnaire
   
   
Disability Claim Form
   
Enrollment Change Form
   
   
Enrollment Form
   
ESI Manual Claim Form
   
   
Formulary Exception Request Form
   
Full-Time Student Status Form
   
   
Graphic Arts Pension Deduction Form
   
HealthLink Open Access III Summary of Benefits
   
   
HIPAA Authorization Forms & Instructions
   
Medical Claim Form
   
   
Medicare Retiree Comparison
   
Medicare Retiree Election Form
   
   
Non-Medicare Retiree Election Form
   
Non-Medicare Value Plan Summary of Benefits
   
   
Status Change Form
 
   
  All forms are in PDF format and require the free Adobe Acrobat Reader. Click the button below to download Acrobot for free.
 
   
  St. Louis Graphic Arts Joint Health & Welfare Fund
14323 South Outer Forty Rd. - Suite S106
Chesterfield, Missouri 63017		 Fund Office: (314) 878-1579
twesthues@slgahw.org
Fax: (314) 275-2640
  If you have any comments about this web site, please contact us at twesthues@slgahw.org.
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