UPS Retiree Health Forms

UPS Retiree Health Fund Form workers holding hands from NY Teamsters Benefits Fund near Syracuse NY

Academic Certification

Form to be submitted for Academic Certification.


Retiree Health Fund - Coordination of Spouse Benefits Form

(NOT to be used for for Active Health Care Coverage) - Form to be submitted for verification of spouse's benefits.


Retiree Health Fund - Annual Coordination of Spouse Benefits Form

(NOT to be used for for Active Health Care Coverage) - Form to be submitted for annual verification of spouse's benefits.


Enrollment Form

Form for enrolling for benefits.


HIPAA Privacy Notice

Notice regarding the Health Insurance Portability and Accountability Act 0f 1996.

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