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Participant Center	For All Participant Groups
Forms Notices General Information	Forms Authorization to Release Protected Health Information (PHI) Form This form should be used if you would like another person or entity other than yourself to receive your protected health information. Change of Address Form (NEW On-Line) This form should be used to notify EIT of your new address. You can also register for an EIT Online Account to make future address changes. Dependent Information Request Form Federal Law now requires that health plans report Social Security Numbers (SSNs) for covered dependents. Please utilize this form to provide SSNs for all dependents. Direct Deposit Form Available from within the Participant Portal. Disability Application Package Disability application instructions and forms to apply for Disability Benefits. (Disability Benefits do not apply to Participants of the Participatory Plan or who are currently covered under COBRA) Disabled Dependent Coverage Application Request for Disabled Dependent Coverage Form. Group Life Beneficiary Designation Form This is a form to fill out and mail to us if you would like to designate a beneficiary or update beneficiary information. Maternity Leave Benefit Statement Effective 1/1/2023, the Plan now offers Maternity Leave Benefits for the Construction, Communication, Miscellaneous, Office and Miscellaneous and Administrative Plans. A Participant who is expecting or has given birth should complete this online Maternity Leave Benefit Statement. Pension Use the forms below for Pension requests. Plan 5 - Beneficiary Designation Form UNDER AGE 59 1/2 - Plan 5 - Full Distribution Forms Package UNDER AGE 59 1/2 - Plan 5 - Partial Distribution Forms Package NEW - Plan 5 - Age 59 ½ Withdrawal Forms Package Qualified Domestic Relations Order (QDRO) Procedures for Qualified Domestic Relations Orders Separate Interest Form Supplemental Unemployment Benefit (SUB) IMPORTANT NOTICE REGARDING THE SUSPENSION OF SUB PLAN BENEFITS Be advised that, at the recommendation of the Joint Arbitration Board, benefits from the Supplemental Unemployment Benefit (“SUB”) Fund will be SUSPENDED until further notice. Please note that certifications submitted for weeks ending after July 12, 2025 will NOT be eligible for payment. Qualified Participants can still submit SUB certifications for periods up through and including the week ending July 12, 2025, provided it is submitted timely, according to Plan provisions. Please continue to complete the SUB Application each time you are laid off to avoid any delay in prospective payments once SUB is reinstated. If you have any questions, please contact the SUB department at 312-782-5442, then press 3. SUB Application SUB Certification Apprentice Training Benefit Application (ASF) If you are an Apprentice and are directed by the fund office to complete the training benefit application prior to starting your class, use this online form. This application must be completed for each class that you attend. Subrogation Questionnaire Workers’ Compensation Disability Statement Useful Tax Forms IL W-4  (Illinois Employee Withholding) IL W-5-NR  (Illinois Nonresidence Statement) IRS W-4  (Federal Employee Withholding) IRS W-4P  (Federal Pension Withholding) IRS W-4S  (Federal Sick Pay Withholding) IRS W-9  (Request for Taxpayer Identification) You must have a PDF reader to open, view, and print a PDF file. Click here to download a PDF reader by Adobe®
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