Local 77 Operating Engineers Funds
MemberXG Benefit system
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Important Notices
Notice of Surprise Billing Protections
Downloads (Forms)
Electronic Funds Transfer (EFT) Form
Annuity Fund Beneficiary Designation Form
Application for Payment of Subrogated Benefits and Repayment Agreement with Instructions
Change of Address Form (Pension Fund)
Change in Beneficiary Form (Health and Welfare)
Change in Beneficiary Form (Pension)
Coordination of Benefits Form
Electronic Funds Transfer (EFT) Form
Enrollment Form
HIPAA Authorization Form
Pension Federal Tax Withholding Form
Request for Federal Income Tax Withholding From Sick Pay
Weekly Accident & Sickness And/Or Maintenance of Benefits Form
Summary Plan Descriptions
Local 77 Health and Welfare SPD
Local 77 Pension Plan SPD
RETIREE FIRST Information 2024
IUOE Local 77 Plan Document Notice
2024 IUOE Local 77 – Age in Letter
2024 IUOE Local 77 FAQ
Download Summary of Benefits and Coverage
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October 2011
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April 2011
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Useful Links
Conifer Health Solutions
CareFirst PPO
CareMark
Delta Dental
Useful Numbers
Conifer Health Solutions 844-739-8913
Carefirst 800-235-5160
Caremark 866-282-8503
Vision Service Plan 800-877-7195
Delta Dental 800-932-0783
These forms are published on this page by Associated Administrators, LLC
on behalf of the Client Fund and are meant solely for the use of their participants.