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Teamsters Western Region & Local 177 Health Care Plan fax number

(602) 324-0555

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Fund Office

Used for: Enrollment submission and changes for Teamsters Local 177 Health Care Plan; benefits processing communications

Fax destination details

Department
Fund Office
Purpose
Enrollment submission and changes for Teamsters Local 177 Health Care Plan; benefits processing communications
Form
Enrollment Form — Enrollment Form for Teamsters Western Region & Local 177 Health Care Plan
Address
P.O. Box 43110, Phoenix, AZ 85080-3110
Voice phone
855-215-2039

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Fill out completely in black ink, sign and date; attach required documents; submit to the Fund Office to have benefits paid and to update enrollment information.

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