By checking this consent box, I acknowledge and agree that:

WA Health Inc., on behalf of the Trust Fund, collects personal information from me, my employer (or former employer), and my union local to determine my eligibility and benefit entitlements under the Plan. Employment history may be shared with my union local for the purpose of monitoring contributions required under the applicable Collective Agreement.

All personal information is kept confidential and safeguarded. Disclosure is limited to the minimum information necessary to administer benefits. WA Health Inc. may share personal information (including information about my eligible dependents) with insurance carriers, benefit providers, auditors, and other service providers only as required for Plan administration, or as required by law.

By providing consent on WA Health Inc.’s website, I authorize WA Health Inc. to collect, use, and store my Social Insurance Number (SIN) for Plan administration purposes, such as enrolment/eligibility verification, claims processing where required, and reporting as required. My SIN will be used only for these purposes, kept confidential, and disclosed only to parties involved in administering the Plan where necessary, or as required by law.

I understand that I may withdraw this consent at any time by contacting WA Health Inc.; however, withdrawing consent may affect WA Health Inc.’s ability to administer my coverage or process certain transactions where a SIN is required.