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Local 488 health and welfare benefits 2026

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The document is a Health Care Benefit Claim Form for the Edmonton Pipe Industry Health and Welfare Plan. It outlines the necessary steps for members to submit claims for health care expenses, including vision care and medical services. Members must complete various parts of the form, provide required information, and attach relevant bills or receipts. The form emphasizes the importance of accuracy and completeness in submissions to avoid delays.

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Click ‘Get Form’ to open the local 488 health and welfare benefits claim form in the editor.
Begin with Part 1, where you will enter your personal information including your name, date of birth, address, and Social Insurance Number. Ensure that you sign the authorization section to validate your claim.
Proceed to Part 2 for vision care details. Fill in the patient's name and relationship to you, and answer questions regarding their employment status and previous eyewear.
In Part 3, itemize your expenses related to vision care. Include dates of service and charges for glasses or contact lenses. Attach any necessary receipts.
Complete Parts 4 and 5 for medical expenses by providing patient details, prescription information, and charges for services rendered. Make sure all fields are filled accurately.

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