Teamsters Local 191 Health Services and Insurance Plan

Trustees

Robert Digirolamo                      Anthony Cappella

Edwin Rooney                              Forrest Harvey

1139 Fairfield Avenue

Bridgeport, CT 06605

Phone: 203-366-5849 

Press #2 for Health services

Phone: 800-972-4099

Fax:      203-331-0348

 Hours

Monday - Friday

      8:00 a.m. - 4:30 p.m.

Please return your 2020 Annual Information Request form 

Please show your ID card to the health care provider

      Your id starts with TSJ followed by 7 numbers.

          

Important information is located on back of card

           Fill in forms to print and mail  

The below forms are here for your convenience. Please contact your Local Fund office first when submitting a claim or providing information.

Medical Massage Reimbursement

 Prescription

Reimbursement

Affidavits

Marital Status

Financial Responsibility

Residence Spouse as of a date

Residence Spouse 

Summary Plan Description

Directions to Health Services office 

Business Meeting

Summary Annual Report

Residence Dependent

Paternity

Authorization to release PHI 

Please contact  Local 191 Health Services office for questions concerning eligibility,  benefits and claim payment.