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 should I invest my account?
Local 94 and the Affiliated Funds staff cannot offer any investment advice. However, you are encouraged to call JW Thompson for personalized investment advice for your Annuity Fund account. You can get an analysis of your finances plus guidance on how to save and invest for retirement. Contact Retire Rite, administered by JW Thompson, by calling (888) 453-1869, Monday through Friday, 9:00 a.m. – 5:00 p.m. ET, or by e-mail jay@jwti.com.