Benefits Interest Form

Together, we can change our healthcare options

Healthcare is an ever-moving target— it’s hard to understand, harder to find good rates. The USFWC has been offering dental and vision coverage, in a first step toward making better health care options available to our members.

Here’s the catch: our rates depend on how many people we have on board. The more people we have, the better our rates will be. With our national network, we know that we have the opportunity to offer fantastic health-related benefits to our membership— we need your help to prove it!

Filling out this form will help us to understand what worker co-ops, democratic workplaces, and partners are interested in our health-related benefits, so that we can negotiate the best possible rate. Please take two minutes to fill it out and let us know you are interested!

Your Information
Benefits Administrative Representative
Please give us the contact information for the administrative representative of my organization who should be contacted about enrolling in this plan.
Organization You Are Representing