Forms that apply to all plans are listed in the table below.
Forms for Managed Care Plan can be found in the Managed Care Plan page.
Forms for Select Choice Plan can be found in the Select Choice Plan page.
These forms can be printed from your computer. Once printed, they can be completed and mailed to the Administrative Office:
Southern California Lumber Industry Welfare Fund
1200 Wilshire Blvd. Fifth Floor
Los Angeles, CA 90017-1906
If you have any questions, please contact the Administrative Office at (562) 463-5080 or (800) 824-4427.
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 | |
|---|---|
| Authorization for the Disclosure of Protected Health Information |  (PDF, 24 KB) |
| Change of Address Notification | (PDF, 55 KB) |
| Life Insurance Beneficiary Designation | (PDF, 7 KB) |
| Request Form for Additional Information | (PDF, 63 KB) |
| Waiver of Initial Coverage & Special Notice | (PDF, 47 KB) |
| Waiver of Existing Coverage | (PDF, 67 KB) |
To Save the document on your computer, right click on , then select Save Target As (or Save Link As).
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.