Full Timer Benefits

This page requires Adobe PDF Reader. Don’t have it? Download it here.

Delta Dental

Delta Dental’s Welcome Page for UUP Members

Delta Dental Claim Form

Davis Vision

Davis Vision’s Welcome Page for UUP Members

Davis Vision Claim Form

Laser Vision Reimbursement Claim Form

Other Benefits Information

Important Phone Numbers (Print and Save as a handy reference)

Benefit Trust Fund Privacy Notice

Benefit Trust Fund HIPAA Authorization Form

Benefit Trust Fund Enrollment Card
(Enrollment Card for dental and vision benefits)

Benefit Trust Fund Group Life Insurance Beneficiary Card

Benefit Trust Fund/UUP Member Change of Address Card

Benefit Trust Fund Change of Marital or Dependent Status Form
(For enrollment changes of dental and vision coverage)

Benefit Trust Fund Direct Payment Application Form
(Information and form for direct payment of dental and vision benefits)