WELFARE FORMS
PENSION FORMS
FREQUENTLY ASKED QUESTIONS
PERSONAL DISCLOSURE INFORMATION
MANION CONTACT LIST
MEMBER BENEFIT BOOKLET

FORMS

PERSONAL DISCLOSURE INFORMATION

In order to protect your privacy, your personal information used for the administration of your benefits cannot be released or discussed with anyone other than yourself – not even your Spouse - unless you specifically request and authorize it. The Personal Information Disclosure Form allows you to authorize the Plan Administrator to release or discuss your personal information relating to the benefits administered on your behalf with certain Third Parties (defined as follows).

Third Parties include:

  • Your spouse or a member of your immediate family (parents, siblings or adult children)
  • The Board of Trustees
  • Your Business Representative and/or Secretary of the Local Union Office.

If you wish the Plan Administrator to release or discuss your personal information with any Third Party (as defined above) please complete the form, sign it and return it to the Plan Administrator in the pre-addressed envelope provided.

If you wish to specifically designate someone who is not identified as a Third Party, to make inquiries on your behalf, or if you don't want your information released to a particular party, please notify us in writing of your wishes.

This form goes into effect on the date the Administrator receives the information and is valid until you wish to change your designation. Your designation may be changed at any time by notifying the Plan Administrator in writing.

If you have any questions or wish to make a specific inquiry please contact the Plan Administrator directly at (416) 234-3511 or toll free at 1-800-263-5621.

 

Personal Disclosure Form

 



READ CAREFULLY, BUT REMEMBER…

This is a general outline of the Plans and its purpose is to explain as briefly and clearly as possible each of the benefits to which you are entitled. The benefits outlined under the Plans are subject to the terms and conditions of the Plan documents and Group Master Policies. If there is any conflict between this outline and the Plan documents and Group Master Policies, the Plan documents and Group Master Policies will apply in all cases. Also remember that no benefits are guaranteed and that the benefits can be changed by the Trustees at any time.

 
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