LOCAL 1010

Benefits

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Benefits Rep. Ernie Barrientez	937‑7784 937‑7784 ext. 117
Benefits Rep. Terra Samuel	937‑7784 937‑7784 ext. 112
benefits@uswa1010.org

Summary Plan Descriptions

Active Wage Fund SPD

Retired Wage Non-Medicare Eligible Fund SPD

Benefits Forms (Active)

2019 Wellness Verification Form

Spouse Coverage Status Inquiry

Spousal Premium Reimbursement

Davis Vision Claim Form

United Concordia Dental Claim Form

Benefits Forms (Retirees)

Aetna Medicare Claim Form

Change of Address Request Form

Direct Deposit Authorization Form

Federal Tax Withholding Form

State Tax Withholding Form

Prudential Life Beneficiary Change Form

Pre-Medicare Healthcare Termination Form

Pre-Medicare Healthcare Enrollment Form

Benefits Links When looking for a provider you must enter your network Medical - BlueCross Blueshield: BCBS PPO/EPO Dental - United Concordia: Advantage Plus 2.0

BlueCross Blueshield

Virtual Medical ID Card Instructions

United Concordia Dental

Davis Vision

CVS/Carmark

ArcelorMittal/USW Benefits

FMLA/S&A Benefit (REED Group)

FMLA Information

S&A claim or FMLA Leave: call the phone number below

844-507-5388 844-507-5388

Coverage Provider Phone #'s (on the back of your cards)

CVS/Caremark 800-345-5413 CVS/Caremark 800-345-5413

ArcelorMittal Retiree Services

(retiree benefits phone tree) 800-356-0078 (retiree benefits phone tree) 800-356-0078

Steelworkers Pension Trust Summary Description

SPT.pdf

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We make the job safe, or WE DON'T DO IT!

Local 1010 Memorial Hall
7047 Grand Avenue
Hammond, Indiana 46323
(219) 937-7784
Fax (219) 937-7684