Forms

Membership Application Form

Grievance Form

Application for Withdrawal Card

Life with Dues Beneficiary Form

Update Personal Information with Local 222 – This form will only update your information at the Local Union Hall. If you need to update information with your insurance and/or pension that must be done separately.

Insurance

Utah Idaho Teamsters/Southwest Service Administrators

855-292-7954

Utah Idaho Teamsters/Southwest Service Administrators Website

Utah Idaho Teamsters/Southwest Service Administrators Enrollment Form

Utah Idaho Teamsters/Southwest Service Administrators Retiree Enrollment Form – Direct Payment Authorization Form HERE

Utah Idaho Teamsters/Southwest Service Administrators Short Term Disability Form

Utah Idaho Teamsters/Southwest Service Administrators Change of Address Form

Utah Idaho Teamsters/Southwest Service Administrators Change of Address – The most efficient way to update your address with the insurance is to log in to your ssaportal at www.ssatpa.com.

Log into ssaportal and click on the "My Account" application then click on the the "Change Address" button. Click on Apps. Select change address. Select update my information & enter current info. Make sure to select update.

Utah Idaho Teamsters/Southwest Service Administrators HRA Claim Form – Q&A HERE

Pension

Western Conference Teamsters Pension

800-531-1489

Western Conference Teamsters Pension Website

Western Conference of Teamsters Pension Beneficiary Designation Form (English)

Western Conference of Teamsters Pension Beneficiary Designation Form (Spanish)

Retired Western Conference of Teamsters Pension Beneficiary Designation Form (English)

Western Conference of Teamsters Pension Change of Address Form