How to Request an Evaluation of Employment
Participants & Retirees
The Plan’s Request for Evaluation of Employment Form must be completed in full if you would like a determination from your Area Administrative Office regarding whether the reemployment you are engaged in meets the Plan's definition of Suspendible Employment.
You may also use this form to request an advance determination regarding reemployment you are contemplating in the future. Included with this form is a document explaining the Plan’s Suspension of Benefit Rules.
To help you understand what the Plan considers to be Suspendible Employment, the downloadable form provided below contains the four crucial questions that must be answered before a determination can be reached.
To download a Request for Evaluation of Employment Form, you will need Adobe® Acrobat® Reader™ on your computer:
Downloadable Form (Adobe® Acrobat® PDF™, 161K)
Once you download the form to your computer, you can print it, fill it in and mail it back to an Area Administrative Office. (You cannot send the form via e-mail.)
PDFs will require Adobe® Acrobat® Reader™ to be installed on your computer. If you don't have Acrobat Reader installed, you can get the latest version of this free software by clicking the Adobe icon to the left. This takes you to the software download page at Adobe's web site.