	1375 Virginia Drive, Suite 102 Ft. Washington, PA 19034 Phone 215-542-8211

Healthful Hints

Contractor Forms

Don't Forget!

It's Your responsibility to update the Funds Office with any dependent changes - Birth of a child, Change in Marital Status, etc.

Quick Links

Health Care Solutions Corporation
XRays, MRIs, Cat Scans & Lab Work
HealthLine 866-955-IUOE
Talk to a nurse 24/7 365 days/year
Independence Blue Cross
Inpatient and Outpatient Provider
Express Scripts
Pharmacy Benefit Manager
Fidelio Dental
Dental Provider
Prudential
Annuity Manager
Vision Benefits of America
Vision Benefit Provider
PCN 800-366-0129
Mental Health Provider

Contractor Forms

Click on the form name to download.

Form Name	Form Purpose
Employer Reporting Form	Blank Monthly Contribution Reporting Form
Remittance Report Example	Remittance Report Example
Reporting Form Instructions-Parent Body	Step by step instructions for completion of Monthly Contribution Reporting Form for Parent Body contractors
Reporting Form Instructions - C-Branch	Step by step instructions for completion of Monthly Contribution Reporting Form for C-Branch contractors
2011 Surcharge Schedule	Surcharge rates effective May 1, 2011
2010 Surcharge Schedule	Surcharge rates effective May 1, 2010
2009 Surcharge Schedule	Surcharge rates effective May 1, 2009
2008 Surcharge Schedule	Surcharge rates effective May 1, 2008
2007 Surcharge Schedule	Surcharge rates effective May 1, 2007
Local 542 County Codes and Districts	Counties, Contract Codes and Districts in Local 542 Jurisdiction

You must have Adobe Acrobat Reader to view and download most of these forms.