Teamsters Local 443 Health Services and Insurance Plan

                              Trustees

   Salvatore J. Abate       Dennis J. McGuire

   Thomas E. Bayusik      Timothy W.Casey                 

       

200 Wallace Street

New Haven, CT 06511

Phone: 203-624-9817

Phone: 800-922-3348

Fax:      203-624-8866

 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

Authorization to release PHI 

Affidavits

Marital Status

Summary Plan Description

Directions to Health Services office 

Business Meeting

Summary Annual Report

Financial Responsibility

Residence Spouse as of a date

Residence Spouse 

Residence Dependent

Paternity

Please contact  Local 443 Health Services office for questions concerning eligibility,  benefits and claim payment.