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Retiree Dependents Form

The LiUNA Local 837 Health & Welfare Plan form collects essential retiree and dependent information for benefit claims processing using this form.

Retiree – Appointment of Beneficiary

The Retiree Appointment of Beneficiary form for LiUNA Local 837 allows retirees to designate or update a beneficiary for insurance proceeds payable upon their death. Members must provide personal information, revoke any previous appointments, and declare a new beneficiary with their relationship to the member.

Retiree Claim Form

The Labourers' Local 837 Health and Welfare Trust Fund Retiree Benefit Plan claim form allows retirees to submit reimbursement requests for eligible medical expenses using this form.