Premium Payment Authorization Forms
Please download and complete the authorization form that applies to your preferred payment method and return it to the Trust Office with your completed Trust Enrollment Form. Please select only one premium payment method.
ACH Authorization Form
For retirees who would like their monthly premium automatically deducted from a checking or savings account.
WA Retirees Only – DRS Pension Deduction Authorization Form
For retirees who would like their monthly premium deducted from an eligible Washington State DRS pension benefit.
ID Retirees Only – PERSI Pension Deduction Authorization Form
For retirees who would like their monthly premium deducted from an eligible Idaho PERSI pension benefit.
Returning Your Forms
Submit your completed payment authorization form together with your Trust Enrollment Form to the Trust Office using the return instructions provided on the enrollment materials.
IAFF HWT Trust Office
PO Box 3852
Seattle, WA 98134-3582
Phone: (877) 624–6219
Email:
Hours: Monday-Friday, 9:00AM – 9:00PM ET (6:00AM – 6:00PM PT)