What is the Spouse Employer Verification Form and why does it need to be filled out?

This form is used to help the Fund Office accurately update records with correct employment and insurance information. Every employed Spouse must fill out the top portion and have the bottom portion completed by their employer. Please either upload this form along with all required documents using the “Secure Upload Center” or mail to the Fund Office at 1811 Spring Garden Street, Philadelphia, PA 19130 prior to April 1st every year. Be sure the member’s name and UBC number are on all documents. Forms completed online will be put on hold and considered incomplete until all documents are received. This will also result in Cafeteria Benefit Payments being withheld.

Click here to download a copy of the current Spouse Form. It is listed under the Health & Welfare section.