Local 77 Operating Engineers Funds

MemberXG Benefit system

Want to check eligibility or the status of your claim? Log on to MemberXG and check your information online, available 24 hours a day, seven days a week.


Important Notices

Annual Funding Notice

Notice of Privacy Practice

Nondiscrimination Notice

Notice of Surprise Billing Protections

Downloads (Forms)

Electronic Funds Transfer (EFT) Form
Annuity Fund Beneficiary Designation Form
Application for Payment of Subrogated Benefits and Repayment Agreement with Instructions
Change of Address Form (Pension Fund)
Change in Beneficiary Form (Health and Welfare)
Change in Beneficiary Form (Pension)
Coordination of Benefits Form
Electronic Funds Transfer (EFT) Form
Enrollment Form
HIPAA Authorization Form
Pension Federal Tax Withholding Form
Request for Federal Income Tax Withholding From Sick Pay
Weekly Accident & Sickness And/Or Maintenance of Benefits Form

Summary Plan Descriptions

Local 77 Health and Welfare SPD
Local 77 Pension Plan SPD

For Your Benefit Newsletters

April 2023

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October 2022

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October 2013
July 2013
April 2013
January 2013
October 2012
July 2012
April 2012
January 2012
October 2011
July 2011
April 2011
January 2011

Useful Links

Conifer Health Solutions
CareFirst PPO
Delta Dental

Useful Numbers

Conifer Health Solutions 844-739-8913

Carefirst 800-235-5160

Caremark 866-282-8503

Vision Service Plan 800-877-7195

Delta Dental 800-932-0783

These forms are published on this page by Associated Administrators, LLC
on behalf of the Client Fund and are meant solely for the use of their participants.