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U.A. LOCAL 22 BENEFIT FUNDS Application for Health Care Reimbursement Use this form only to be reimbursed for qualified Internal Revenue Code Section 213 medical expenses. These expenses include COBRA,
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UA Local B22 Benefit is a retirement and benefit plan specifically for members of the local union.
Members of the local union who are eligible for benefits are required to file UA Local B22 Benefit.
To fill out UA Local B22 Benefit, members need to provide their personal information, work history, and any relevant beneficiary information.
The purpose of UA Local B22 Benefit is to provide retirement and benefit security for members of the local union.
Members must report their work hours, wages, and any changes in personal information on UA Local B22 Benefit.
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