LOCAL 8A-28A FUNDS
Plan Documents
Please contact the fund office for plan documents.
Forms
Health & Welfare
Medical Enrollment Package
(English)
Medical Enrollment Package (Spanish)
Life Insurance Enrollment
(English)
Life Insurance Enrollment
(Spanish)
Dependent Removal
Form
Optical Benefits Fee
Schedule
401K
Enrollment Package
(English)
Enrollment Package
(Spanish)
Loan Application
(English)
Loan Application
(Spanish)
Hardship Withdrawal
Application (English)
Hardship Withdrawal
Application (Spanish)
Distribution Application
(English)
Distribution Application
(Spanish)
Age 59.5 Distribution
Application (English)
Age 59.5 Distribution
Application (Spanish)
Partial Distribution
Application (English)
Partial Distribution
Application (Spanish)
401(K) Employee Deferrals
Election Form (English)
401(K) Employee Deferrals
Election Form (Spanish)
Elective Deferrals Distribution
Application
Benefit Funds
Health & Welfare
Find a Medical Provider
Find a Vision Screening
Find a Vision Provider
Find a Dental Provider
Surprise Billing Rights Notice
Transparency in Coverage
Contact List
Medical
MagnaCare: 1-800-226-5116
Pharmaceutical
EmpiRx: 1-877-241-7123
Dental
DDS, Inc: 1-800-255-5681
Vision
Vision Screening: 1-800-652-0063
CPS Optical: 212-675-5745
Member Assistance Program
914-417-5355
401K
Access Your 401K Account
Trustees & Professionals
Trustees
Union Trustees
Joe Azzopardi
John Drew
Albert Blair
Management Trustees
Lina Gottesman
Professionals
Fund Administrator: Joseph Ramaglia
Fund Counsel: Barnes, Iaccarino & Shepherd & Pitta & Giblin LLP
Fund Accountant: Marshall & Moss, LLP
Fund Auditor: Novak Francella, LLC
Fund Consultant & Actuary: Segal Company
Contact
Local 8A-28A Funds
36-18 33rd Street
Long Island City, NY 11101
Phone: 718-361-1770