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ADMINISTRATION OFFICEth4 DISTRICT IBEX HEALTH FUND 3150 US Route 60 * On, WV 25545 Telephone: (304) 5250331 * Fax: (304) 5256005 www.4thdistricthealthfund.com DESIGNATION OF BENEFICIARY(IES) Participant

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How to fill out 4 district ibew health

01

To fill out 4 district IBEW health, follow these steps:

02

Start by gathering all the necessary information and documents required to fill out the form.

03

Read the instructions carefully to understand the eligibility criteria and requirements for the health plan.

04

Fill out the personal information section, providing accurate details such as name, address, contact information, and social security number.

05

Provide information about your current employment, including the name of the employer, job title, and duration of employment.

06

Indicate your selection of health plan options offered by the 4 district IBEW health.

07

If applicable, provide information about dependents who will be covered under the health plan.

08

Sign and date the form, acknowledging that all the information provided is truthful and accurate.

09

Review the completed form to ensure there are no errors or missing information.

10

Submit the filled-out form as instructed, either by mailing it to the designated address or submitting it online if available.

11

Keep a copy of the completed form for your records.

12

Note: It is recommended to consult the 4 district IBEW health's official website or contact their customer service for any specific instructions or clarifications.

Who needs 4 district ibew health?

01

The 4 district IBEW health is designed for individuals who are part of the International Brotherhood of Electrical Workers (IBEW) and fall within the specified districts.

02

Typically, anyone who is a member of the IBEW and resides within the 4 district jurisdiction can benefit from the 4 district IBEW health plan.

03

This includes electricians, linemen, telecommunications workers, and other related professions within the electrical industry.

04

Additionally, eligible family members and dependents of IBEW members may also be covered under the 4 district IBEW health plan.

05

To determine eligibility and specific requirements, it is best to contact the 4 district IBEW health directly or refer to their official documentation.

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What is 4 district ibew health?

4 district ibew health is a healthcare plan designed for members of the International Brotherhood of Electrical Workers (IBEW) in the 4th district.

Who is required to file 4 district ibew health?

Members of the IBEW in the 4th district who are eligible for the healthcare plan are required to file for coverage.

How to fill out 4 district ibew health?

To fill out 4 district ibew health, eligible members must complete the necessary forms provided by the plan administrator and submit any required documentation.

What is the purpose of 4 district ibew health?

The purpose of 4 district ibew health is to provide affordable and comprehensive healthcare coverage to members of the IBEW in the 4th district.

What information must be reported on 4 district ibew health?

Members filing for 4 district ibew health must report their personal information, dependents, employment status, and any other relevant healthcare coverage.

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