What Forms Should I Return?

Reviewing forms to return
 
 

Please refer to the chart below for a list of the forms we need returned, based on your Fund coverage for 2020. If you have any questions, please contact Member Services at 1-818-243-0222 or email us at musicians@pacfed.com.

COVERAGE

Life Insurance Only

FORMS TO RETURN

Life Beneficiary Form*
Waiver of Coverage Form

COVERAGE

Dental & Vision Only**

FORMS TO RETURN

Life Beneficiary Form*
Dental / Vision Enrollment Form

COVERAGE

Full Benefit Package***

FORMS TO RETURN

Life Beneficiary Form*
Level A, B or C Enrollment Form

*Effective January 1, 2020 you will not have Life and AD&D coverage unless you return a beneficiary form to indicate that you are enrolling in the Fund’s Life and AD&D program through Prudential Life Insurance Co.

**New for January 1, 2020, the Fund is offering a Dental & Vision Only benefit; you do not have to enroll in a medical plan to have a dental/vision benefit. This option is available to those who qualify at Levels A & B. A premium may be required.

***The full benefit package is not only medical coverage, but includes dental and vision, if you have qualified at Levels A & B.

 
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