Western teamsters welfare trust 2026

1. Click ‘Get Form’ to open the Western Teamsters Welfare Trust Enrollment and/or Change Participant Data Form in the editor.
2. Begin by filling out the Participant Data section. Use blue or black ink and print all information clearly. Include your Social Security Number, date of birth, last name, first name, middle initial, marital status, address, employer details, and union local number.
3. Next, move to the Eligible Dependent Data section. List all eligible dependents as defined in the instructions. Provide their names, dates of birth, relationship to you, social security numbers, and indicate if they reside with you.
4. If any dependents do not reside with you, complete the additional information required for those dependents in the designated section.
5. Fill out the Other Insurance Data section if you or your dependents have coverage under another health care plan. Provide details about the type of coverage and insurance company.
6. Finally, review all entered information for accuracy before signing and dating the form at the bottom. Ensure that you return it to Northwest Administrators as instructed.

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