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ILIUM WELFARE PLAN 1188 FRANKLIN STREET, SUITE 101 SAN FRANCISCO, CA 94109 Telephone (415) 6738500 FAX (415) 7491400AUTHORIZATION for USE or DISCLOSURE OF PROTECTED HEALTH INFORMATION (PHI) Name:
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Find-opencomsan-franciscoilwu-pma-benefitilwu-pma benefit funds san is a form used to report benefits provided by ILWU-PMA Benefit Funds in San Francisco.
Employers who provide benefits covered under ILWU-PMA Benefit Funds in San Francisco are required to file this form.
The form can be filled out manually or electronically, following the instructions provided by ILWU-PMA Benefit Funds.
The purpose of the form is to ensure that employers are properly reporting the benefits provided to employees under ILWU-PMA Benefit Funds in San Francisco.
Employers must report detailed information about the benefits provided, including the type of benefits, amount, and recipient details.
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