Prospective Employer Documents

 

Please contact the Administrative Office for a copy of Trust Agreement, Summary Plan Document and WRAP document.

 

These documents are available to participating employers only.

 

IMPORTANT!

 

*All documents (including binder check) must be received by the 20th of the month prior to the 1st to assure coverage.*

 

1. Adoption Agreement 2022  – Completed and signed by company officer.

 

2. Attachment A 2022 – Completed and signed by company officer.

 

3. Group Application – Completed and signed by company officer.

 

4. Enrollment Checklist

 

Note: Only appointed agency and participating employers can request documents.