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SOUTHERN CALIFORNIA DRUG BENEFIT FUND 2220 HYPERION AVENUE LOS ANGELES, CALIFORNIA 90027 TEL (323) 6668910 FAX (323) 6639495 WWW.UFCWDRUGTRUST.Ornate: April 2024 To:All Retirees in CA except Retirees

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How to fill out drug fund retiree premium

01

Obtain necessary forms from your employer or insurance provider

02

Provide personal information such as name, address, and social security number

03

Review available plans and select the one that best fits your needs

04

Fill out the enrollment form with the chosen plan information

05

Submit the completed form to your employer or insurance provider

Who needs drug fund retiree premium?

01

Retirees who are eligible for drug fund benefits and wish to enroll in a premium plan

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What is drug fund retiree premium?

Drug fund retiree premium is the contribution made by retirees towards the cost of prescription drugs.

Who is required to file drug fund retiree premium?

Retirees who are eligible for prescription drug coverage through the fund are required to file drug fund retiree premium.

How to fill out drug fund retiree premium?

Drug fund retiree premium can be filled out online through the fund's website or by submitting a paper form through mail.

What is the purpose of drug fund retiree premium?

The purpose of drug fund retiree premium is to help cover the cost of prescription drugs for retirees.

What information must be reported on drug fund retiree premium?

Information such as personal details, coverage options, and premium payments must be reported on drug fund retiree premium.

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