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Applications Active & Retired Forms rank & file supervisor retired CCPOA Benefit Trust Fund www.ccpoabtf.org A guide to benefits offered by the CCPOA Benefit Trust Fund to CCPOA members and.

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How to use or fill out the Ccpoabtf Org online

This guide provides comprehensive instructions for effectively completing the Ccpoabtf Org form online. Whether you are a first-time user or need a refresher, this step-by-step approach ensures you can navigate the application smoothly.

Follow the steps to complete the Ccpoabtf Org form with ease.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your full name as it appears in your official documents. Ensure it is printed clearly.
  3. Provide your birthdate in the designated format. This should match your identification documents.
  4. Fill in your Social Security Number (SSN) in the respective field for identification purposes.
  5. Input your residential address, including street, city, state, and ZIP code. Accuracy is crucial for processing your application.
  6. Select your gender by marking the appropriate box. This information may be required for demographic purposes.
  7. List the names and birth dates of your spouse and dependents under 26 years old. Provide birth dates as required.
  8. Choose your plan selection at the current monthly rate by checking the appropriate option that suits your situation.
  9. Sign and date the form once all sections are completed. Your signature authorizes payroll deductions.
  10. Review all entered information for accuracy before submitting your application.
  11. Mail your application to the CCPOA Benefit Trust Fund office at the provided address after folding and sealing it.
  12. Finally, save any changes made if applicable, and consider downloading or printing a copy of your completed form for your records.

Start filling out your application online today to benefit from the programs offered!

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Union dues are only$20.00 per month. This provides a $10,000 basic life insurance benefit, $2,000 spouse benefit. When you reach age 60 this reduces to $5,000; $1,000 spouse.

Piggyback is a supplemental program provided by the CCPOA Benefit Trust Fund that helps to offset the out-of-pocket expenses incurred from the usage of your Dental, Vision and Hearing Aid programs.

The CCPOA Medical Plan is available only to CCPOA members and administered through Blue Shield of California. Sign-up for the Medical Plan occur once a year during Open Enrollment, or upon graduation from the Academy as a new Correctional Officer. You may be eligible for the Diabetes Prevention Program.

Gold Shield provides a 75% benefit for non- occupational disabilities – if you can not work any occupation and the injury or illness is so severe that after 24 months of benefits, you cannot perform two basic “Activities of Daily Living” (includes bathing, dressing, toileting, transferring, continence and feeding) .

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