Forms
Find and download different forms relating to Local 94 and its affiliated Benefit Funds.
Local 94 Forms
Annuity Fund Forms
- For all Annuity Fund Forms, such as a distribution request, loan application or beneficiary form, please visit the mylife.jhrps.com. website.
Health and Benefit Trust Fund Forms
- OptumRx Home Delivery Order Form
- OptumRx Prescription Reimbursement Form
- Empire Claim Form (PDF)
- Sele-Dent Claim Form (PDF)
- Coordination of Benefits Form (PDF)
- Beneficiary Designation Form (PDF)
- Commercial Loss of Time Claim Form (PDF)
- School Loss of Time Claim Form (PDF)
- Authorization to Release PHI Form (PDF)
- Commercial In-House Claim Form (PDF)
- School Retiree Medicare Related Premium Reimbursement Form
- School In-House Claim Form (PDF)
Pension Forms
- For all Pension forms, such as beneficiary, direct deposit, and retirement application forms please visit the Central Pension Fund website.
Scholarship Fund Forms
Sick Fund Forms
FAQs
How do you calculate the new helper’s rate for a member under the RAB agreement?
Helpers employed by a RAB employer and new to the industry start at 70% of the current full helper rate, provided you are enrolled in the Training Fund. Helpers generally get a 5% increase every six months. Typically, helpers also get a raise on January 1 of each year, because the full helper’s rate increases then, according to the collective bargaining agreement.
You can request a rates and dues sheet. Please call the Union Office at (212) 331-1800. You can also visit the Contact Us page for more information.