welfare fund

Forms that apply to all plans are listed in the table below. These forms can be printed from your computer. Once printed, they can be completed and mailed to the Administrative Office:
Benefit Programs Administration
1200 Wilshire Blvd. 5th Floor
Los Angeles, CA 90017

If you have any questions, please contact the Administrative Office at (888) 806-8942
Office Hours: 8:30 am – 4:30 pm, Monday through Friday
Closed on major holidays. There is an after-hour answering machine to leave a message on.

ALL PLANS Forms
Plan Choice Form view
Kaiser Enrollment/Change Form view
DeltaCare USA Enrollment Form view
HealthNet Enrollment Form view
Union Labor Life Insurance Enrollment/Change Form view

To Save the document on your computer, right click on view, then select Save Target As (or Save Link As).

Disclaimer:
Health benefits are available only if your employer participants in the Welfare program by paying the proper contributions. If you are in doubt as to whether contributions are being made on your behalf, check with your employer or the Administrative Office.
Disclaimer: The information provided on this website should not be solely relied upon, as it is based on currently available information that is subject to change.
If you have any specific questions concerning the information contained on this website, please contact the Administrative Office.
In the event of a conflict between the information contained in this website and the plan documents, the plan documents will be controlling.