UFCW 8 Golden State FoodMaxx Benefit Guide 2017
This official publication outlines the new UFCW Comprehensive Benefits Trust plan for FoodMaxx members starting January 1, 2018. It provides critical information on coverage options, plan benefits, and important contact details for members. Stay informed about your benefits and how to utilize them effectively.
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How do I fill this out?
Filling out this form is straightforward. Begin by carefully reading the instructions provided in the guide. Ensure you have all necessary information available before proceeding with the form.

How to fill out the UFCW 8 Golden State FoodMaxx Benefit Guide 2017?
1
Read the benefits guide thoroughly.
2
Gather your personal and dependent information.
3
Complete the required fields on the form.
4
Review the form for accuracy.
5
Submit the form through the designated method.
Who needs the UFCW 8 Golden State FoodMaxx Benefit Guide 2017?
1
FoodMaxx employees who require health benefits.
2
Retirees seeking information on their benefit options.
3
New members of UFCW 8-Golden State needing to enroll.
4
Agents or representatives assisting members with enrollment.
5
Dependents of members who need to understand their coverage.
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What are the instructions for submitting this form?
To submit this form, you have several options. First, you can email the completed form to benefits@ufcw.org. Alternatively, fax it to (800) 552-2401 or mail it to UFCW Benefit Trust, P.O. Box 4100, Concord, CA 94524. Make sure all information is complete and accurate to avoid delays in processing.
What are the important dates for this form in 2024 and 2025?
Open Enrollment for the new benefit plan will be held starting in mid-October 2017. Members should look for their Open Enrollment packets in the mail at that time. It's crucial to keep track of these dates to ensure you don’t miss out on necessary enrollment steps.

What is the purpose of this form?
The purpose of this form is to inform UFCW 8-Golden State FoodMaxx members about their new health benefits starting January 1, 2018. It serves as a comprehensive guide outlining the various coverage options available. Understanding these benefits is essential for members to maximize their healthcare resources and ensure proper enrollment.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: This section requires members to input their name, contact details, and identification numbers.
- 2. Dependent Information: Here, members will list eligible dependents for coverage under the new plan.
- 3. Plan Selection: Members choose their preferred health plan option from available choices.
- 4. Signature: This field allows members to sign and certify the accuracy of the information provided.
- 5. Submission Instructions: Guidelines are provided for how to submit the completed form.
What happens if I fail to submit this form?
Failing to submit this form can result in a lapse in health coverage for you and your dependents. It is important for members to complete this process to ensure they are enrolled and eligible for benefits. Missing this deadline may mean you will have to wait until the next enrollment period.
- Lapsed Coverage: Without submission, you risk losing access to health benefits.
- Financial Impact: Inability to access health coverage may lead to significant out-of-pocket expenses.
- Ineligible Dependents: Failure to report dependents may exclude them from receiving necessary health benefits.
How do I know when to use this form?

- 1. Open Enrollment: Complete this form to enroll in or change your health plan.
- 2. Updating Information: Use this form to update your dependent information.
- 3. Life Changes: This form is essential to reflect changes due to life events.
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