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Please Note: In order to view and print the following forms, you must have the Adobe Acrobat Reader installed on your computer. If you
do not have the Adobe Acrobat Reader Software and wish to download it, you may do so by clicking on the image below.
Assignment of Benefits
BCBSIL Enrollment Form and Yearly Coordination of Benefits and Dependent Status Statement
Statement For Loss Of Time Benefits
Student Verification
IBEW Local Union 9 Health Care Benefits Web Site
6525 Centurion Drive, Lansing, MI 48917-9275 Phone (877)IBEW-155 Fax 517.321.7508
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