Health Plan

Acknowledgement of Summary Plan Description Provisions/Subrogation
Address Change Form
Authorization Form – Protected Health Information
Cancellation of Authorization – Protected Health Information
Enrollment Form
Extended Benefit Recurring Credit Card Payment
Extended Benefits Form – Worker’s Compensation
Reimbursement Agreement Form – Worker’s Compensation
Special 14 Day Weekly Income Benefit COVID-19 Quarantine Application Form
Stepchild Affidavit
Weekly Income Benefit Continuation Form
Weekly Income Claim Form – HI Employer Only
Weekly Income Claim Form – NJ Employer Only
Weekly Income Claim Form – NY Employer Only
Weekly Income Claim Form (Except NY, NJ, HI Employers)
Your Rights and Protections Against Surprise Medical Bills

Pension Plan

Address Change Form
Benefit Option Outline
Designation of Beneficiary – Pre-Retirement Death-In-Service Benefit
Enrollment Form for Direct Deposit of Pension Payments
Local 1 Elevator Consultant Program Enrollment Request Form and Agreement
Pension Application
Pension Instructions
Pension Release Authorization Form
QDRO Procedures
Retiree Authorization form for Direct Payment to NECPAC
Retiree Beneficiary Change Form
Withholding Certificate for Pension or Annuity Payments W-4P

Annuity Plan

Address Change Form
Beneficiary Form
Contribution Form – 401(k)/Roth Contribution/Enrollment/Deferral Change Form
Emergency Coronavirus-related (Phase 2 period) Distribution Application
Rollover Form

Educational Videos

Reading your annual retirement statement

About your 401(k) retirement benefits

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contact resource card


Important phone numbers and websites

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This website provides an overview of benefits for eligible members of National Elevator Industry Benefit Plans. Refer to the Summary Plan Description (SPD) or plan contract/certificate and plan amendments for a full description of benefits. If there is a discrepancy between the information provided on this website and the official plan documents, the information provided in the official plan documents will govern.