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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
Direct Deposit is now mandatory for all payments including Pension, Supplemental Unemployment and Disability.

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)

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. Qualified Domestic Relations Order (QDRO) Request for Disabled Dependent Coverage
Request for Disabled Dependent Coverage Form.

Supplemental Unemployment Benefit (SUB)
As of 3/29/2020, EIT is no longer accepting paper/email/fax applications or certifications. You must use the online forms below. 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)
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