Shortfall Fund Contribution Request

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Shortfall Fund Contribution Request

Contribution Period: July 1, 2022 through Dec. 31, 2022.

Applications will be considered in the order they are received.

Your total health plan contributions may be viewed through the Local 802 Member Portal:

https://info.local802afm.org/

For additional information please visit:

https://www.local802afm.org/contracts/shortfall-funds/

You may begin filling out the form below now. Applications will be considered in the order they are received. Please remember to press SUBMIT at the end of the form.

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