Northern California Pipe Trades Trust Funds
for UA Local 342

935 Detroit Avenue, Suite 242A Concord, CA 94518-2501
Phone: 925/356-8921 | Fax: 925/356-8938 | E-Mail: tfo@ncpttf.com

RETIREE Enrollment / Change Forms

Choose the applicable Enrollment / Change Form for the Health Plan selection you are choosing.

Important:

For Kaiser Permanente and Blue Shield of California HMO Plans, there are limited coverage service areas within Northern California.

The Blue Shield of California HMO Plan is not available if a Participant and/or any Dependents are eligible for Medicare.

Back to main Health and Welfare page

Blue Shield of California PPO and HMO Retiree Enrollment / Change Form
Kaiser Permanente HMO Retiree Enrollment / Change Form

To view PDF files you will need the free Adobe™ Acrobat Reader®
Terms of Use | Privacy Statement
This site is best viewed with Internet Explorer 9.0 or higher, Firefox 1.5 or higher, Safari 2.0 or higher.