Employer Forms & Notices
Make sure you understand important Plan information and forms
The Trust Fund does not discriminate on the basis of race, color, national origin, age, disability, or sex.
To ask for assistance in your primary language, see the Notice of Nondiscrimination.
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Contact the Trust Fund Office
If you have questions or need assistance contact us at
1-800-922-9902 Option #2
Write us an email
DC16contributions@hsba.com – For questions related to regular contributions or monthly remittances.
DC16collection@hsba.com – For questions related to collection notices or payroll audits.
DC16iremit@hsaba.com – For questions related to online reporting or i-Remit registration.
DC16info@hsba.com – For questions related to eligibility or claims.
General Forms & Notices
Health & Welfare
To ensure proper reporting and payment of participant contributions to the fund, please submit your completed Subscriber Agreement via the electronic DC16 Subscriber Agreement Submission Form.
See Exhibit B attached within each agreement for Frequently Asked Questions and required Employer and Employee signed attestation.