Downloads

Annual Funding Notice

  1. Plan Year Ending December 31, 2017 Annual Funding Notice
  2. Plan Year Ending December 31, 2018 Annual Funding Notice

Annuity Summary Material Modification (SMM)

  1. Annuity Plan SMM - November 2017
  2. Annuity Fund COVID-19 SMM (April 2020)

Collections

  1. Reciprocal Form

Health

  1. Health Reimbursement Form
  2. HRA Pay Provider Direct Form
  3. Appendix A for HRA
  4. Spouse Employment Verification Form (2021)
  5. 2021 Coordination of Benefits Form - Active
  6. Spouse Maiden Name Form
  7. Hearing Aid Benefit

Health Summary Material Modification (SMM)

  1. Health Fund COVID-19 SMM (April 2020)
  2. Health Plan Eligibility Requirements SMM - February 2018

Medicare

  1. Blue Medicare Advantage Plan - Evidence of Coverage (2021)

Pension Summary Material Modification (SMM)

  1. Pension Plan Earning Benefits SMM - November 2018
  2. Pension Disability Pension SMM - November 2017

Retirement

  1. Pension & Annuity Direct Deposit Form
  2. Active Loan Payment Deferral
  3. Allocated Investment Losses

Standard Forms

  1. Change of Address

Summary Annual Reports

  1. New Jersey Annuity SAR - Plan Year Ending December 2018
  2. New Jersey Annuity SAR - Plan Year Ending 2019
  3. New Jersey Health Fund Retiree SAR - Plan Year Ending December 2018
  4. New Jersey Health Fund SAR - Plan Year Ending December 2018
  5. New Jersey HRA SAR - Plan Year Ending December 2018
  6. New Jersey Health Fund Retiree SAR- Plan Year Ending 2019
  7. New Jersey Health Fund SAR - Plan Year Ending 2019
  8. New Jersey Health Reimbursement Account (HRA) SAR - Plan Year Ending 2019

Summary Plan Descriptions (SPDs)

  1. Pension Summary Plan Description
  2. Annuity Summary Plan Description
  3. Vacation Fund Summary Plan Description
  4. Health Plan Summary Plan Description