Downloads (Forms)
Enrollment Form
Privacy Statement
HIPAA Authorization Form
HIPAA Authorization Form (Spanish)
Summary Plan Description Booklets
Local 68 Health & Welfare Fund SPD
Summary of Benefits and Coverage
OptumRx Prescription Plan Information
OptumRx Customer Service: 1-800-797-9791
OptumRx Website: https://www.optumrx.com/public/landing
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.