H&W Provider Links

BlueCross Blue Shield IL
Delta Dental
Elite Administration
VSP Vision Care
Blue 365 Discount Program

H&W Forms Resource

Thank you for visiting the Forms Resource Page.
Please click on the images below
to view/download forms.

Enrollment Form

Address Change Form

Dependent Change Form

Coordination of Benefits Form

Short Term Disability Form

VSP Reimbursement Form

BCBSIL Claim Form

Delta Dental Claim Form

OptumRx Claim Form

Accident Form

Local 399 - Terms | Copyright (c) 2023 International Union of Operating Engineers - Local 399
IUOE Local 399 Union Hall and Training Facility • 2260 S. Grove St. Chicago, IL 60616 • Tel: 312-372-9870 • Fax: 312-842-1590