When you need to enroll in a program, add a dependent, or file a claim, just print the appropriate form, complete it as  instructed, and then mail it to the following address:

Los Angeles Machinist Benefit Trust
PO Box 6149 Garden Grove, CA 92846
Phone: (714) 898-2200
Toll Free: (800) 499-8121
Fax: (925) 405-0659

Make sure that you forward any required documentation along with your form. If you are enrolling/adding a dependent due to marriage, a child’s birth, or an adoption, be sure to provide proof of dependency. A certified copy of your marriage certificate, or a child’s birth certificate, or a court order showing legal responsibility will be acceptable.

If you ever need assistance, feel free to contact the Administrative Office at 714-898-2200 or 1-800-499-8121.

For Active Employees


Active Enrollment Form
Blue Shield Active Application Form
Special Enrollment Form for Children Dependents Age 9-25


Dental Benefit Comparison Charts—High, Medium, Low


Kaiser Enrollment Form
Blue Shield Application


VSP Enrollment Form
MES Enrollment Form

Disability Forms

Disability Form
Aetna Disability Form

Life Insurance Forms

Aetna Life Insurance Claim Form
Aetna Life Beneficiary Designation Form

For Retirees


Enrollment Form


Cigna Dental Enrollment Form
Dental Benefit Comparison Charts—High, Medium, Low


Blue Shield+65 Retiree Application
Behavioral Health Clinician Statement Form


MES Enrollment Form

Claims and Eligibility

For Claims and Eligibility information
please contact
Corcoran Administrators at
(714) 898-2200 or
(800) 499-8121