Teamsters Local 671A  Health Services and Insurance Plan

Trustees

 David  Lucas                            Craig Timpson   

 Anthony Lepore                      Donald Shubert

22 Britton Drive
Bloomfield, CT 06002

 

Fund Manager

 Janice Fenlason 

 

Phone: 860-289-3409

Fax:      860-528-3658

 Hours

Monday - Friday

      8:00 a.m. - 4:30 p.m.

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

Authorization to release PHI 

Affidavits

Marital Status

Financial Responsibility

Directions to Health Services office 

Summary Plan Description

Business Meeting

Summary Annual Report

Residence Spouse as of a date

Residence Spouse 

Residence Dependent

Paternity

Please contact  Local 671A Health Services office for questions concerning eligibility,  benefits and claim payment.

Please review the Summary Plan Description for further information regarding your plan of benefits.