Welcome to the Fund Office website. 

Forms

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
Authorization Agreement for Direct Payments MassMutual's form for automatic Loan Payments 401K
Beneficiary Designation Form for adding a beneficiary 401K
Catch up Contribution Change Form Election form participants 50 or over who can contribute additional funds over standard IRS limit 401K
Claim Form HRA
Claim Form - Recurring and Third Party To file for recurring claims payable to a third party HRA
Continued Coverage for Disabled Child HRA
Dependent Change Form Form to add dependents HRA
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
HRA - Opt Out Form HRA
HRA -Attestation Form HRA
HRA Enrollment Form HRA
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
Insurance Premium Reimbursement Claim Form HRA
Investment Election Form 401K
Legal Name Change Form HRA
PHI Release Form Authorization to release personal health information HRA
Rollover Statement 401K
Savings Contribution Form Form to specify or change rate contribution 401K
Spanish - Beneficiary Designation Form for adding a beneficiary. 401K
Spanish - Savings Contribution Form Form to specify or change rate contribution 401K
Waiver of QPSA Form for participant's spouse to waive rights to the preretirement survivor annuity 401K
Withdrawal Liability Estimate Request Information for participating employers about requesting a withdrawal liability estimate. Pension Plan

Homepage - Announcements

USW HRA: Summary of Material Modifications 3.17.2021 Now Available

Click Here

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.