This folder contains important forms that must be completed to update our records, as well as information about the Health Fund coverage.
Please complete:
- New Participant Registration Form
- The Dependent Enrollment form, if applicable (You must prepay a $150 quarterly dependent premium in order for dependents to be eligible for coverage, family must be added by 30 days of your coverage start date.)
- Health Authorization for Release of Information form (Complete this form ONLY if you want to designate someone other than yourself to call on your behalf and receive personal information about you, i.e., a business manager or spouse)
- Pension Authorization Release Form
- The Designation of Life Insurance Beneficiary form
- The Coordination of Benefits form
Also enclosed are documents for your review:
- Paid Parental Leave Guide
Please take a moment to fill out the forms and send them directly to the Fund
Office at the following address. Enclosed is a self-addressed envelope for your
convenience.
Writers’ Guild – Industry Health Fund
2900 W Alameda Ave Suite 1100
Burbank CA 91505
Please take a moment to review the attached information. If you have any questions, feel free to contact the Eligibility Department at the Fund Office, (818) 846-1015, or visit our website at www.wgaplans.org.
<Link to Paid Parental Leave Guide>
<Link to Dependent Enrollment Form>
<Link to Health Authorization Release Form>
<Link to Pension Authorization Release Form>
<Link to Designation of Life Insurance Beneficiary Form>
<Link to Coordination of Benefits Form>