Frequently Asked Questions

Health Benefits

How do I get a new Health Benefits ID Card?

You can request a new Health Benefit ID card through MyAccount, or you can contact our Member Services Department at (646) 473-9200 and a representative can request one for you.

How do I change my address on file with the Benefit Fund?

You may change your address online at MyAccount or call our Member Services Department at (646) 473-9200.

How much do I pay for benefits?

Your employer makes contributions on your behalf for your benefits. As long as you follow plan rules and receive covered services from 1199SEIU providers, you should not have any out-of-pocket expenses for your health benefits.

What do I need to submit to enroll my spouse and/or child for benefit coverage?

You will need to submit copies of your marriage certificate and your spouse’s Social Security card to enroll your spouse. To enroll your child(ren), you will need to submit a copy of the child’s birth certificate showing that you are the child’s parent, and a copy of the child’s Social Security card.

I’m having trouble enrolling my spouse for benefits.

You may enroll your spouse for benefits through MyAccount. You will need to submit copies of your marriage certificate and your spouse’s Social Security card. If those documents are in a language other than English, you will need to provide translated copies.

Does the Benefit Fund offer international healthcare coverage?

You may pay for certain healthcare services received outside the U.S. and then submit a medical claim for reimbursement with supporting documentation requirements to be reimbursed.

How do I waive benefits?

To waive benefits, you must request a waiver form, complete it and return it to the Benefit Fund. If your spouse or adult child wants to waive coverage, they must complete their own waiver forms. When you waive coverage, it is for your health benefits only. You will continue to receive life insurance, disability and Paid Family Leave benefits.

I am no longer employed; how long does coverage stay active?

You have 30 days of extended coverage from your last day of employment. You may be able to apply for COBRA continuation of coverage for yourself and/or your covered eligible dependents for up to 36 months.

Eligibility

How long is my waiting period for benefits?

You are generally eligible for benefits after you have been working for a contributing employer for 90 days or more, and the employer has made contributions to the Fund for 30 days or more.

To what age can my eligible children be covered for health benefits?

Your eligible dependent children can be covered for healthcare benefits until the age of 26.

Can I enroll my parents for coverage under my health benefits?

No, only your legal spouse and your biological or adopted children can be covered as eligible dependents under your Fund benefits.

Can I add my domestic partner to my benefits?

Domestic partners are not eligible for coverage through the Benefit Fund, but spouses regardless of gender are eligible for coverage.

What is Coordination of Benefits?

The Fund requires you to coordinate coverage for your spouse if you are married and your spouse is enrolled for health coverage. If your spouse has access to health coverage through his or her own job or any other means, the Benefit Fund will coordinate benefits payments with the other plan. One plan will pay its full benefits as a primary insurer, and the other plan will pay secondary benefits. This prevents duplicate payments and overpayments.

How can I make my COBRA payments online?

You can make your COBRA payments online through MyAccount. If the COBRA participant is your spouse or adult child, that individual must use MyAccount to create his or her own account in order to make an online payment. Once the COBRA participant creates an account, he or she will be able to view and pay any outstanding COBRA invoices by clicking on the “Online Payments” tab.

Life Insurance

What is the value of my life insurance policy through the Benefit Fund?

During your first year of work the value of your life insurance policy is $1,250. After your first year, the value of the policy is based on your Wage Class and annual rate of pay. The maximum value of the life insurance benefit is $50,000 per member.

Leaves of Absence

What types of leaves are available?

National Benefit Fund members may receive Paid Family Leave, Family Medical Leave, Worker’s Comp and Disability Leave. You can access the required forms to apply for these leaves on MyAccount.

How long can I take off work during a leave?

For Paid Family Leave, you can receive up to 12 weeks of leave at 67 percent of your average weekly wage, capped at 67 percent of the New York State Average Weekly Wage. For a Disability Leave, you may be eligible for up to 26 weeks of short-term disability benefits based on your wage, as well as continuation of your health benefits.

Do I get paid when I’m on leave from work?

When I am on a leave do my benefits continue?

Yes, your benefits will continue uninterrupted if you are on approved leave. Approved leaves include Paid Family Leave, Family Medical Leave, Workers’ Comp or Disability Leave. You will need to provide proof of your specific approved leave for your benefits to continue.

Disability

How do I apply for disability?

You must complete Part A of the New York State Notice and Proof of Claim for Disability Benefits, have your doctor complete Part B of the form and your employer complete Part C of the form. You must then submit the completed form to the Benefit Fund’s Disability Unit.

I submitted paperwork for my disability claim. What is the status?

You may contact our Member Services Department at (646) 473-9200 for information on the status of your disability claim.

When will I get my disability check?

If you elect to receive your disability payments by physical check you should receive your first payment 7 to 10 days from the approval of your claim. If you elect to receive your disability payments by direct deposit you should receive your first payment 3 to 5 days from the approval of your claim.

Claims

When will I get my money back for the doctor’s bill I paid?

To request reimbursement for a doctor’s bill, complete the Member Reimbursement Medical Claim Form and mail it to 1199SEIU Benefit Funds, PO Box 1007, New York, NY 10108-1007. You can expect to receive your medical reimbursement approximately 60 days after submitting your completed reimbursement form to the Benefit Fund.

What is an EOB statement?

An Explanation of Benefits (EOB) is a statement that describes what costs your plan will cover for medical and dental care you’ve received. Your provider submits a claim to the Benefit Funds for the services you’ve received, and the Funds process the claim for you. An EOB is then mailed to your address on record to inform you about the outcome of that claim. If your spouse and adult children are covered by your 1199SEIU benefits, EOBs on their treatments will be mailed to them at their addresses on record.

I received a bill but I don’t understand it. How can I get help?

You may contact our Member Services Department at (646) 473-9200 for help understanding a bill. Actively working members and their eligible enrolled dependents should not have any out-of-pocket expenses for covered services they receive from 1199SEIU participating providers.

What information do I need to submit a reimbursement claim?

You must complete a Member Reimbursement Medical Claim Form and submit it to the Fund for reimbursement. The form requires information about the 1199SEIU member, the patient for whom the service was provided, and completion of a section by the doctor who provided the service for which you were charged.

What is the status of my claim appeal?

You may contact our Member Services Department at (646) 473-9200 for information about the status of your claim appeal.

Union

How do I join the 1199SEIU Credit Union?

The 1199SEIU Credit Union is administered through the Union, not the Benefit Fund. You may contact the Credit Union at (212) 957-1055 for more information.

I do not see Union dues deductions on my paycheck?

Union dues are collected by the Union, not the Benefit Fund. You may contact the Union Dues Department at (212) 603-3799 or your Union organizer for more information.

Why isn’t my health coverage active while Union dues are being deducted from my paycheck?

Your Union dues are separate from your benefits. You must enroll for health coverage through the Funds by completing an Enrollment Form. You may complete the form on MyAccount or access the form on the Forms for Members page.

Direct Deposit

How do I submit a direct deposit form?

You may submit a direct deposit form to receive your pension or disability payments. To submit a direct deposit form for your pension payments, visit MyAccount to complete and submit your Pension Payment Election Form online. Alternatively, you may email the completed form to [email protected] or fax it to (646) 473-8747.

To submit a direct deposit form for your disability payments, visit MyAccount and complete a Direct Electronic Deposit Authorization for Disability Benefits form. Alternatively, you may fax it to (646) 473-6768.

Pension and Retirement

When am I vested for a pension?

If you have accumulated 5 years of vesting service, you are eligible to receive a pension through the Pension Fund.

I applied for my pension and I have not received my check yet. How can I find out the status of my application?

You can verify your pension by contacting the Funds Retiree Member Services Department at (646) 473-8666.

How can I request a pension estimate?

Simply follow these steps:

Click on the “Pension” tab.
Choose “Request & Review Pension Estimate” from the dropdown menu.
Click on “Request New Pension Estimate.” You will then be asked to review your personal information and make any edits, if necessary.
Click “Confirm and Continue” and review your employment information, making any edits, if necessary.
Click “Confirm and Continue” and review your request, typing in your name and checking the “Accept (E-Signature)” box.
Click “Confirm and Continue” and you will receive a “Pension Estimate Summary” confirmation and should receive your pension estimate within 48 hours.

If you make changes and submit documentation, it may take up to 45 days for your information to be verified and your estimate to be completed. Once the update is completed, an estimate will be e-mailed to you.

How do I apply for my pension online?

Click on the “Pension” tab, then choose “Apply for Pension” from the dropdown menu and follow the steps. We strongly encourage you to schedule an online appointment with a Pension Counselor, who can walk you through the process. If you have questions, you may call (646) 473-8666. If you make changes and submit documentation, it may take up to 45 days for your information to be verified and your application to be completed.

Financial Wellness

How do I access home mortgage assistance?

We regularly host webinars for members offering advice on homebuying and mortgage assistance through the Benefit Fund. You may be eligible to borrow against your earned pension if you are a first-time homebuyer and are vested. Visit our Financial Wellness page for more information.

Training and Employment Benefits

How do I sign in to MyTEF for training benefits?

You may visit MyTEF to create or sign in to your account to access your training benefits.

Child Care Benefits

How do I access Child Care Fund benefits?

Registration for most benefits through the Child Care Fund begins each Fall. You may register for benefits through the Child Care Fund on MyAccount.

MyAccount

Who can use MyAccount?

All 1199SEIU members and retirees can use MyAccount. To create an account, visit the “Sign Up for MyAccount” page and follow the prompts.

You will need to confirm your identity by supplying your Member ID number (found on your Health Benefits ID card), the last four digits of your Social Security number and your date of birth.

What can I see in MyAccount?

Contact information that the Funds have on file for you, such as your address(es), phone number(s) and email address(es)
Employer information that the Funds have on file for you
Your eligibility for medical, dental and prescription benefits
Your family members that the Funds have on file for you
Your life insurance beneficiaries that the Funds have on file for you
Your medical claims, along with the ability to view and print Explanation of Benefits (EOB) statements. To access older EOBs, please call the Funds Member Services Department at (646) 473-9200.
Retirees can view and print their IRS Form 1099-R for pension benefits received, beginning with the 2008 tax year
Retirees can view their pension payment history and update their direct deposit information

Can I see my dental claims or EOB statements in MyAccount?

Dental claims and Explanation of Benefits (EOB) statements are not available in MyAccount. Please see LINK for information on how you can access your dental claims and EOB statements.

Can I see my spouse’s claims in MyAccount?

No, you cannot see your spouse’s claims in MyAccount. However, if your spouse is covered by your 1199SEIU benefits, your spouse can create his or her own personal account. To create an account, your spouse will need to confirm his or her identity by supplying the Member ID number listed on his or her Health Benefits ID card (it is the same Member ID number issued to you). Your spouse will also need to supply the last four digits of his or her Social Security number and his or her date of birth.

Can I see my children’s claims in MyAccount?

No, you cannot see your children’s claims in MyAccount. If your child is younger than 18 years old, you can call the Funds Member Services Department at (646) 473-9200 to inquire about his or her claims. If your child is an adult (18 years old or older) and is covered by your 1199SEIU benefits, that adult child can create his or her own account. To create an account, your adult child will need to confirm his or her identity by supplying the Member ID number listed on his or her Health Benefits ID card (it is the same Member ID number issued to you). Your adult child will also need to supply the last four digits of his or her Social Security number and his or her date of birth.

Can I use MyAccount to update my information when it changes?

Yes, you can use MyAccount to update your information when it changes. You can also use MyAccount to:

Change your address
Enroll your eligible dependents
Coordinate your spouse’s benefits
Change, add or remove your life insurance beneficiaries
Find out the status of a claim
Upload documents when submitting medical, hospital or vision claims for reimbursement
Upload documents when submitting Medicare Part B premium reimbursement claims for you and your spouse (for eligible National Benefit Fund retirees only)
View Explanation of Benefits statements (EOBs)
Request a new Health Benefits ID card
Request a pension estimate
Apply for your pension
Enroll in the Benefit Funds Prenatal Program
Register for benefits offered by the 1199SEIU Child Care Funds
Apply for training benefits through the 1199SEIU Training and Employment Funds

How can I see the payments link in MyAccount?

You will see the payments link only if you are the person responsible for a payment to the Benefit Funds. If you do not see the link, you have no payment obligation to the Funds. The link for COBRA payments may not appear on an 1199SEIU member’s account if the payment is associated with another individual who is on COBRA, such as a spouse or child. If the COBRA participant does not have his or her own account, he or she will need to create one. Once the COBRA participant creates an account, he or she will be able to view and pay any outstanding COBRA invoices by clicking on the “Online Payments” tab.

I submitted an enrollment change form through MyAccount. What is the status?

You may call our Member Services Department at (646) 473-9200 to check the status of your enrollment change request.