Our site is currently under construction. We apologize for any dead links, but hope to finish construction by September. OUR SERVERS ARE CURRENTLY DOWN AND WE CANNOT RECEIVE FILE TRANSFERS IN OUR HRA AND 401K PORTALS. HOPING TO HAVE SERVICE RESTORED SOON 5/15/2025
TAX INFORMATION IMPORTANT HEALTH COVERAGE TAX DOCUMENTS Responsible individuals may receive a copy of their Form 1095-B (Health Coverage) by calling our Fund Office at 800.251.4107or 855.450.1875, by emailing a request to hra@uswbenefitfunds.com, or by ma
TAX INFORMATION
IMPORTANT HEALTH COVERAGE TAX DOCUMENTS
Responsible individuals may receive a copy of their Form 1095-B (Health Coverage) by calling our Fund Office at 800.251.4107or 855.450.1875, by emailing a request to hra@uswbenefitfunds.com, or by mailing a request to USW HRA Fund, 1101 Kermit Drive, Suite 800 Nashville, TN 37217. Once your request is received, a copy of your Form 1095-B will be furnished within 30 days.
Forms
| Form Name | Description | Form Category | Download |
|---|---|---|---|
| 401(k) QDRO Form Model | 401K | ||
| Application for Beneficiaries | Contact the Fund Office at 1-800-474-8673 to request an application. | Pension Plan | |
| Application for Pension | Contact the Fund Office at 1-800-474-8673 to request an application. | Pension Plan | |
| Application for Spouse of Pre-Retirement Employee | Contact the Fund Office at 1-800-474-8673 to request an application. | Pension Plan | |
| Claim Form | HRA |
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| Claim Form - Recurring and Third Party | To file for recurring claims payable to a third party | HRA |
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| Continued Coverage for Disabled Child | HRA |
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| Dependent Change Form | Form to add dependents | HRA |
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| Empower Acquisition Disclosure | 401K |
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| Form W-9 | IRS form W-9 to provide correct tax payer identification number (i.e. Social Security Number) | Pension Plan | |
| Form W4P | IRS form to elect or change tax withholding | Pension Plan |
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| HRA - Attestation Form 2024 | HRA |
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| HRA - Opt Out Form | HRA |
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| HRA Enrollment Form | HRA |
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| HRA Forms | Please find HRA Forms on the HRA Account Login Page. To get there, hover over the LOGIN menu option and select HRA Account Login. | HRA | |
| Information Release Form | Authorization for information release (used for pension application). | Pension Plan |
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| Insurance Premium Reimbursement Claim Form | HRA |
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| Legal Name Change Form | HRA |
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| PHI Release Form | Authorization to release personal health information | HRA |
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| Waiver of QPSA | Form for participant's spouse to waive rights to the preretirement survivor annuity | 401K |
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| Withdrawal Liability Estimate Request | Information for participating employers about requesting a withdrawal liability estimate. | Pension Plan |
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Welcome to the Fund Office!
USW Benefit Funds comprises three Taft-Hartley Trusts:
- The PACE Industry Union-Management Pension Fund (PIUMPF)
- The USW Industry 401(k) Fund
- The USW HRA Fund
Each Fund is governed by a Board of Trustees with both labor and management. All must be negotiated and must be included in the collective bargaining agreement.