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    • Board of Trustees
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    • Applying for a Withdrawal
    • Forms
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    • Summary Annual Reports (SAR)
    • Summary Plan Description (SPD)
    • FAQ
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    • Board of Trustees
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    • FAQ
  • Welfare Plan
    • Board of Trustees
    • Annual Notifications
    • Forms
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    • Life Insurance Certificate
    • Notice of Privacy Practices
    • Plan Document/Summary Plan Description
    • Procedures for Self Payments
    • Quarterly Fringe Statement
    • Retiree and COBRA Premium Rates
    • Summary Annual Reports (SAR)
    • Welfare Amendments
    • Welfare FAQ
  • I-Site EOBs
  • Forms
  • News
  • Service Providers
    • BCBS Provider Lookup
    • Coaching by Hines
      • MD Form 2019
    • Consociate
      • HRA Reimbursement Form
      • Mobile App Video
    • Employee Assistance Program (EAP)
    • Humana
    • MDLIVE Virtual Visits
      • MDLIVE Video
    • Medical Advocate Program (MAP)
    • MedTrak Rx
    • TruHearing (VSP)
    • Vision Service Plan (VSP)
      • (VSP) Vision Benefits Summary
      • (VSP) Out Of Network Form
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Forms

Instruction Sheet for Filling Out ULLICO’s Designation of Beneficiary Form

Health & Welfare Ullico Beneficiary Designation Form

1700 52nd Avenue
Suite B
Moline, Illinois 61265
Phone – (309) 764-8080
Fax – (309) 764-3438

Office Hours
Monday – Thursday
8:00 a.m. – 5:00 p.m.
Friday
8:00 a.m. – 4:30 p.m.

  • Annuity & Profit Sharing Plan
  • Pension Plan
  • Welfare Plan
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