Skip to content

New Delta Dental PPO Plan Coming - Click here for more information
RETIREES: 2023 Pension Payment Verification (PPV) Update

  • About the Fund
  • Contact Us
  • My Portal
Southern California United Food & Commercial Workers Unions and Food Employers Joint Benefit Funds
  • About the Fund
  • Contact Us
  • My Portal
  • Health Care
    • Health Care Benefits
    • Active Participants
      • Plan Benefits Charts
        • Platinum Plus Plan A
        • Platinum Plus Plan B
        • Silver / Gold Plan A
        • Silver / Gold Plan B
        • Gold Plan A
        • Gold Plan B
        • Platinum Plan A
        • Platinum Plan B
      • Medical
        • Indemnity PPO Medical Plan
        • Preventive Care
        • Death Benefit
        • Disease Management Program
        • Knee/Hip Replacement
        • Podiatry
        • Health Reimbursement Account
        • HEALTH MAINTENANCE ORGANIZATIONS (HMOs)
      • Prescription Drugs
        • Prescription Drug Program
        • Special Therapeutic Drugs
      • Dental/Orthodontic Care
      • Vision
      • Employee Member Assistance Program
      • Chiropractic Care/ Acupuncture
    • Retirees
      • Retirees Except Class E
      • Class E Retirees
    • AD & D Benefits
    • Health Care FAQS
    • Forms & Documents
    • COVID-19 (Coronavirus) Updates
  • Wellness
    • Health and Wellness Links
    • Incentives- Active PPO Participants
  • Retirement
    • Pension Plans
      • Plan A-1
      • Plan A-2
      • Plan B-1
      • Plan B-2
    • Retirement FAQs
    • Forms & Documents
    • COVID-19 (Coronavirus) Updates
  • Education
    • Scholarships & Tuition Assistance
      • Scholarship Award Program
      • Tuition Assistance Program
    • Education FAQs
    • Forms & Documents
  • Eligibility & Enrollment
    • Active Participants
      • What’s My Plan?
      • Eligibility
        • Active Participants
        • Dependents
        • Step-up Benefits
        • Continuing/Re-establishing Eligibility
      • Enrollment
        • Enrolling When You Become Eligible
        • Open Enrollment
      • Payroll Deductions
      • Making Changes/Life Events
    • Retirees
      • Eligibility
        • Retirees
        • Dependents
      • Enrollment
        • Upon Retirement
        • Open Enrollment
        • Medicare Enrollment
      • Monthly Costs
      • Making Changes/ Life Events
    • Eligibility & Enrollment FAQs
    • Forms & Documents
    • Open Enrollment
  • Calendar & Deadlines

Enrollment-Form-Platinum-Plus-Medical-Plan Fillable

Enrollment-Form-Platinum-Plus-Medical-Plan Fillable

LEGAL NOTICES

Non-Discrimination Notice | HIPAA Notice of Privacy Practices

© Copyright 2017 SCUFCW, all rights reserved | Site Map | Website Terms of Use & Privacy Policy

Web Development & Design by Matrix Group International, Inc.
Southern California United Food & Commercial Workers Unions and Food Employers Joint Benefit Funds Administration, LLC
×

Southern California United Food & Commercial Workers Unions and Food Employers Joint Benefit Funds Administration, LLC