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Have a safe summer!


Welcome to ACT Online! Here you can find Local 1776's latest services including news, information, our contracts, highlights from our newsletter The Spirit of '76 and much more!

 


Items of Interest

Click to download PDF versions of:

Current Philadelphia Contract

Special Information

Click to download PDF versions of:

Vision Enrollment Form

Prior Authorization Form (for prescription drugs)

Out of Network Claim Form

Dependent Certification Form

Flu Vaccine Reimbursement Forms

Hardship Request Form

United Concordia Enrollement Change Form

Davis Vision Reimbursement Claim Form

 

 


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