DENTAL REIMBURSEMENT
For Active Employees and Dependents Only
Effective January 1st, 2008 the administration of the dental benefits of the Pipe Health and Welfare Fund of Colorado is being handled by Fringe Benefits Services, Inc., instead of Cigna. All itemized statements for dental services and proof of payment should be sent to:

Colorado Pipe Dental Benefits
C/O Fringe Benefits Services, Inc.
P.O. Box 21240
Denver, CO 80221

Or fax to (303) 429-1359
Attn: Dental Reimbursements

Please provide the following when you submit your dental claims:
1. Member’s name
2. Member’s SSN
3. Member’s address
4. Copy of the dental bill
5. Copy of receipt showing payment
6. Write “Colorado Pipe Dental Benefits” on the bill or receipt

Each member is eligible up to a $400.00 combined family calendar maximum reimbursement. Submission of the bill does not constitute eligibility. If you would like to verify your eligibility, please call (303) 745-1596.

INSURANCE ENROLLMENT FORM
Please fill out the Enrollment Form and submit the forms to the office on the form. Please include a copy of a marriage certificate if adding a new spouse; and a copy of the birth certificate when adding a new dependant. Please be aware stepchildren are not eligible for coverage unless they are legally adopted by the member, and common law marriage will require additional legal and tax papers. If you have any questions on coverage, please contact Lori at (303)745-1596.

JURY DUTY
Please fill out the Request for Jury Duty Pay form completely and mail it along with your Summons for Jury Duty and Jury Service Certificate to:

Plumbers Local No.3
17100 E. 32nd Place
Aurora, CO 80011

Applications will be viewed and approved by the Executive Board which meets every 4th Wednesday of the month. If approved, the checks will be issued after the meeting. Please note your employer is liable for $50.00 a day for the first 3 days of jury duty service. Thereafter, the court will pay $50.00/day for your service.

LANSVILLE SCHOLARSHIP
Only active Plumbers Local No.3 members' children who are entering college or a union trade are eligible for the scholarship. Applicants can only apply for the Frank Lansville scholarship one (1) time. Please submit the completed application with verification of payment for your tuition. Applications are viewed and approved by the Executive Board which meets every 4th Wednesday of the month. If approved, the checks will be issued after the meeting.

UA SCHOLARSHIP
The United Association scholarship is now accepting applications. Please check with their website at www.ua.org for the latest information and rules. It must be postmarked by June 15, 2010 to be accepted this year.

BENEFICIARY FORM
Please make sure the percentages on your Plumbers Local No.3 Beneficiary Form equal 100% if you have designated more than one beneficiary. If you wish the second beneficiary to become the primary beneficiary in the event of the primary beneficiary’s death, please indicate that on the form. You may use two forms if you need more room.

NATIONAL PENSION
If you need to fill out a new beneficiary form for your pension, please contact the hall at (303)739-9300 to request the form be mailed to you. Or if you have any questions about your account and need to contact National Pension directly, call 1-800-638-7442.