Forms & Notices
Make sure you understand important Plan information and forms
The Trust Fund does not discriminate on the basis of race, color, national origin, age, disability, or sex.
To ask for assistance in your primary language, see the Notice of Nondiscrimination.
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Kaiser Permanente – Helping you stay Covered
Kaiser Permanente – Ayudándole a mantenerse cubierto
Notice of Privacy Practices
Important Information about the Smart Choices/Healthy Rewards Program
Enrollment Booklet: Use this form to enroll, change your name, address, plan, marital status, dependent(s).
Smart Choices Instructions
Kaiser Instructions on Completing an Online or In-Person Health Education Course
MedExpert QMMS Web Portal Access Instructions
VSP 60% Savings on Digital Hearing Aids
2019 Indemnity PPO Medical Plan Preventative Care Guidelines
VSP Individual Visions Plans for Retirees
WellDyneRX – WellView Member Portal & Cost Calculator Tool
WellDyneRX 2019 Clinical Focus Formulary (English)
WellDyneRX 2019 Clinical Focus Formulary (Spanish)
Medicare Part D Notice of Creditable Coverage
WellDyneRx Prescription Delivery Service Terms
WellDyneRx Prescription Delivery Service Form
WellDyneRx Free OneTouch Glucose Meter