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Union Forms


Prescription - Medco Direct Reimbursement Claim Form - This form should be used by employees of Local 200United who are participants in the healthcare plan provided by 1199, who paid for their prescription, and are requesting reimbursement from Medco (Pharmacy Provider).  It can also be used as a coordination of benefit form if the employee's covered dependent also has prescription coverage elsewhere.

Temporary Assignment Application (pdf) - This form is used to request temporary assignment to other Skidmore employment opportunities.

Union Bid Form - This form is now only available for on-line submission at

Union Personnel Action Form - This form is used by supervisors to report changes in status for union personnel.