Teamsters Local 1035 Health Services and Insurance Plan

Trustees

Robert Ziobrowski                             Paul Novak

Glenn Barksdale                              James Stack

400 Chapel Road 

Unit 2B

South Windsor, CT 06074

 

Phone: 860-528-4159

Fax:      860-528-3389

 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

Reimbursement lien agreement 

Authorization to release PHI 

Affidavits

Marital Status

Financial  Responsibility 

Residence Spouse as of a date

Summary Plan Description

Directions to Health Services office 

Business Meeting

Summary Annual Report

Residence Spouse 

Residence Dependent

Paternity

Please contact  Local 1035 Health Services office for questions concerning eligibility,  benefits and claim payment.