- Blank Beneficiary Form – July 2024
- Enrollment – MWR Dental & Vision – 2024
- Claim Form – Delta Dental
- MWR Member Reimbursement Claim Form – Transportation
- MWR Member Reimbursement Claim Form – NPLH
- MWR Member Reimbursement Claim Form – Hearing Aids
- MWR Member Reimbursement Claim Form – Fitness Center
- MWR Member Reimbursement Claim Form – Cataract
- Nursing Home Medicaid Opt-Out – Cover Letter
- Nursing Home Medicaid – Confirmation Form
- MWR Pre-Medicare Retiree Opt-Out
- MWR Medicare Retiree Opt-Out
- Retiree Opt-In Form
- Electronic Fund Transfer Authorization Form
- Appealing a Denied Claim
- Authorization to Use or Disclose Health Information
- OON Vision Claim
Middletown Works Hourly & Salaried Union Retirees Healthcare Fund