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.

Authorization for the Disclosure of Protected Health Information view (PDF, 24 KB)
Change of Address Notification view (PDF, 55 KB)
Life Insurance Beneficiary Designation view (PDF, 7 KB)
Request Form for Additional Information view (PDF, 63 KB)
Waiver of Initial Coverage & Special Notice view (PDF, 47 KB)
Waiver of Existing Coverage view (PDF, 67 KB)

To Save the document on your computer, right click on view, 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.
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.