LABORER'S NATIONAL

HEALTH & WELFARE FUND

TOLL FREE: 1-800-540-0113

FAX: 202-318-0654

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    Forms //

    2021 Enrollment Form
    2021 Enrollment Form

    English and Espanol

    FORMULARIO DE INSCRIPCIÓN
    FORMULARIO DE INSCRIPCIÓN
    UPDATE ADDRESS
    UPDATE ADDRESS

    Claim Forms//

    VISION CLAIM FORM
    VISION CLAIM FORM
    DeltaDental CLAIM FORM
    DeltaDental CLAIM FORM

    Temporary Identification Cards//

    ID CARD ESI TEMP.pdf
    ID CARD ESI TEMP.pdf
    ID CARD Dental TEMP
    ID CARD Dental TEMP
    ID CARD Cigna TEMP
    ID CARD Cigna TEMP

    © 2017 by Laborers' National Health & Welfare Fund