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  • Electrical Workers Local Union 159 Retirement Plan
  • Wisconsin NECA-IBEW Retirement Plan
  • Employers
  • Participants
  • Summary Plan Description
  • Announcements
  • Forms & Links
  • Frequently Asked Questions
  • HIPAA
  • Employee Assistance Program
  • LiveHealth Online
  • UHC Group Medicare Advantage Plan
  • Anthem Pre-Paid Claim Form
  • Sword Health
  • Contact Information
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Documents

Forms & Links

Forms
  • Address Change Request Form
  • Authorization Agreement for ACH Debits for Retirees
  • COBRA Premium Waiver
  • Coordination of Benefits Form
  • Dependent Re-Enrollment Form
  • Disability Claim Form
  • Flex Forms
  • Flexible Benefit Acct. Automatic Self-Payment Premium Deduction Form
  • Authorization for Release of Health Information
  • Insurance Premium Flex Reimbursement Form
  • Long Term Disability
  • Member Account Authorization for Release
  • OTC Covid 19 Test Reimbursement Form
  • Retiree Notification Form
  • Sub Account Forms
  • Sub Fund W-4 Form
  • Subrogation Accident Report Form
  • Subrogation and Reimbursement Agreement
  • United Health Care Retiree Advantage Plan Cancellation Form
  • Vacation Fund Direct Deposit Form
  • POS/PPO Network
  • Online Destination for EAP Support and Services (Employer = WEEBF)
  • Northwestern Mutual Long Term Disability
  • LiveHealthOnline and/or LiveHealthOnline Behavioral Health
  • Sword Health

Wisconsin Electrical Employee Benefit Fund
2730 Dairy Drive Suite 101
Madison, WI 53718
Phone: (608) 276-9111
Phone: (800) 422-2128

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