WA Alaska Laborers Health and Security Fund Medical/Dental/Time Loss Claim Form 2014 free printable template
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S Medical / Dental / Time Loss Claim Form ALASKA LABORERS HEALTH AND SECURITY FUND A Self-Funded Health Plan P. O. Box 34567, Seattle, WA 98124-1567 Instructions: Complete this form, attach all itemized
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How to fill out WA Alaska Laborers Health and Security
How to fill out WA Alaska Laborers Health and Security Fund
01
Obtain the WA Alaska Laborers Health and Security Fund application form.
02
Read the instructions carefully before starting to fill out the form.
03
Fill in your personal information, including your name, address, and contact details.
04
Provide your social security number and other required identification documents.
05
Detail your employment history, including the names of the employers and duration of employment.
06
Attach any necessary supporting documents, such as proof of employment or beneficiaries.
07
Review your application for accuracy and completeness.
08
Sign and date the application form.
09
Submit the application via the designated method (mail, online submission, etc.).
10
Keep a copy of the submitted application for your records.
Who needs WA Alaska Laborers Health and Security Fund?
01
Employees working under the jurisdiction of the WA Alaska Laborers Union.
02
Laborers who wish to access health and security benefits for themselves and their family members.
03
Workers who meet the eligibility requirements set by the fund.
04
Those in need of healthcare coverage and other support services provided by the fund.
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What is WA Alaska Laborers Health and Security Fund?
The WA Alaska Laborers Health and Security Fund is a health and welfare fund that provides health related benefits to eligible laborers in Washington and Alaska.
Who is required to file WA Alaska Laborers Health and Security Fund?
Employers who have collective bargaining agreements with the Laborers' Union in Washington and Alaska are required to file the WA Alaska Laborers Health and Security Fund.
How to fill out WA Alaska Laborers Health and Security Fund?
To fill out the WA Alaska Laborers Health and Security Fund, employers must complete the designated forms by providing accurate employee information, wages, and hours worked, and then submit them by the deadline.
What is the purpose of WA Alaska Laborers Health and Security Fund?
The purpose of the WA Alaska Laborers Health and Security Fund is to ensure that laborers have access to health care and security benefits, promoting their overall well-being and financial security.
What information must be reported on WA Alaska Laborers Health and Security Fund?
The information that must be reported on the WA Alaska Laborers Health and Security Fund includes employee names, Social Security numbers, hours worked, and total wages for the reporting period.
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