No Frills UFCW Benefit Trust Fund Enrolment Form
This form is intended for new enrolment and modifications related to the No Frills/UFCW Benefit Trust Fund. It collects essential personal and dependent information for plan members and their beneficiaries. Ensure you submit the completed form to the plan administrator as directed.
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How do I fill this out?
To fill out this form, begin by providing your personal details, including your name, contact information, and plan specifics. Next, include information regarding any dependent children and their relevant data. Finally, complete the sections for direct deposit enrollment and beneficiary designation to ensure your claims are processed correctly.
How to fill out the No Frills UFCW Benefit Trust Fund Enrolment Form?
1
Complete the plan member information section fully.
2
Fill in the dependent children information, if applicable.
3
Choose your preference for direct deposit by completing the banking information.
4
Designate beneficiaries for your insurance effectively.
5
Review the form thoroughly before submission to ensure accuracy.
Who needs the No Frills UFCW Benefit Trust Fund Enrolment Form?
1
New employees enrolling in the UFCW Benefit Trust Fund.
2
Existing members making modifications to their current benefits.
3
Parents or guardians of dependent children needing to include them in the plan.
4
Members wishing to set up direct deposit for claims reimbursement.
5
Individuals needing to designate beneficiaries for their insurance.
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What are the instructions for submitting this form?
To submit this form, ensure you have filled it out completely and accurately. You may send it via email to nofrillsufcw@pbas.ca, or you can fax it to (416) 674-1525. Alternatively, you can mail the completed form to 110 - 61 International Blvd. Toronto, ON M9W 6K4. Take a copy for your records and keep it safe.
What are the important dates for this form in 2024 and 2025?
Important dates regarding submissions and plan renewals for the No Frills/UFCW Benefit Trust Fund in 2024 and 2025 will be announced by your plan administrator. Ensure you are aware of these dates to maintain continuous coverage and benefits. Regularly check for updates or notifications from your employer regarding changes to the plan.
What is the purpose of this form?
The purpose of this form is to facilitate the enrolment and modification process for members of the No Frills/UFCW Benefit Trust Fund. It collects essential information regarding the members, their dependents, and beneficiaries to ensure smooth administration of benefits. Additionally, it allows members to express preferences regarding payment methods and coverage.
Tell me about this form and its components and fields line-by-line.
- 1. Plan Member Information: Contains personal identification details such as name, SIN, and contact information.
- 2. Dependent Children Information: Collects data on any dependent children including their names and birthdates.
- 3. Direct Deposit Enrollment: Requests banking information for direct reimbursement of claims.
- 4. Designation of Beneficiaries: Allows members to designate beneficiaries for their insurance payments.
- 5. Authorization and Declaration: Signatures and consent regarding information sharing and plan enrollment.
What happens if I fail to submit this form?
Failure to submit this form may result in delays in your benefit coverage or claims processing. It is crucial to complete and submit the form accurately to ensure all benefits are properly administered. Missing information can lead to reduced coverage or ineligibility.
- Coverage Delays: Delayed submissions might cause a lapse in your benefit coverage.
- Claim Rejections: Incomplete forms can lead to claim denials or processing issues.
- Potential Gaps: Not submitting could result in gaps in coverage for dependents.
How do I know when to use this form?
- 1. Initial Enrollment: When joining the UFCW Benefit Trust Fund for the first time.
- 2. Modifications: To make changes to your current benefits or personal information.
- 3. Dependent Additions: Add dependent children to your existing plan for coverage.
- 4. Beneficiary Designation: Designate or update beneficiaries for your insurance.
- 5. Direct Deposit Setup: Enroll in direct deposit to receive claims directly into your bank account.
Frequently Asked Question
What is the purpose of this form?
The form is to enroll or modify benefits for members of the No Frills/UFCW Benefit Trust Fund.
How do I submit the completed form?
Submit the original form to the plan administrator via email or mail as specified.
Can I enroll my dependent children?
Yes, there is a section to include dependent children in your benefits.
How do I set up direct deposit?
Complete the direct deposit section with the required banking information.
What if I change my beneficiaries?
You can update your beneficiary designations anytime by completing a new form.
Is there a deadline for submission?
Ensure your form is submitted in accordance with any specified timelines outlined by your employer.
What should I do if my information changes?
Fill out a new form to update any personal or dependent information.
Can I save my progress?
Currently, the site allows you to edit and download, but it does not support saving progress.
What happens if I forget to fill out a section?
Incomplete sections may result in delays or rejection; review your form carefully before submission.
What should I do if I have questions while filling out the form?
Reach out to your plan administrator or employer for assistance on any form-related queries.
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