1. Complete the Enrollment Form choosing the benefit options that best meet the needs of your JATC classes.
  2. Choose the Coverage Option for your Local:
    • a. Option 1 – Excess Plan 1 (not available in ID, ME, OH, OK,OR SD)
    • b. Option 2 – Primary Plan 2
    • c. Option 3 – Primary Plan 3
  3. Select:
    • a. No Weekly Indemnity
    • b. Or $200 Weekly Indemnity
    • c. Or $400 Weekly Indemnity
  4. Calculate the annual premium for your Local (policy minimum is $150.00) and mail the completed, and signed Enrollment Form to:
    • Mass Benefits
      PO Box 828
      Annandale, VA 22003-0828

Questions?

Contact Theresa Willett
e-mail: twillett@massbenefits.com
or call 1-800-221-3083.

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Download Enrollment Form


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