Heat & Frost Insulators and Allied Workers'


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Forms
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  • Assignment of Benefits Form

  • Medco by Mail Order Form

  • Master Medical Claim Form

  • Statement For Loss Of Time Benefits

  • Change of Address Form

  • Blue Cross Enrollment Form, Yearly Coordination of Benefits and Dependent Status

  • Beneficiary Designation Form

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    6525 Centurion Drive, Lansing, MI 48917-9275
    517.321.7502 • Toll-free 800.323.8079 • Fax 517.321.7508