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- About 1199SEIU
In New York City, Long Island and the northern suburbs, tens of thousands of 1199SEIU members-about half our union members-work at institutions that belong to the League of Voluntary Hospitals and Homes or the Greater New York Nursing Home Association, or at institutions whose contracts are patterned on them. These master contracts have provided a level of healthcare, pension and other benefits that surpass those of most healthcare workers in our country through our 1199SEIU National Benefit and Pension Funds (NBF). Our goal is to eventually elevate all of our members to this level of benefits. But that is not now the case.
Find Your Benefits:
Florida | Maryland / DC | Massachusetts | NYC/LI | Upstate NY
1199SEIU members in Florida, Maryland/DC, New Jersey, Massachusetts and those parts of New York that do not belong to the NBF should refer questions about their benefits to their organizers.
Health Benefits
More than 200,000 members of 1199SEIU have won comprehensive healthcare coverage — hospitalization, doctors’ visits, dental and vision care, prescription drugs, etc. — with no or minimal out-of-pocket expenses for themselves and their families. In all, the benefit covers more than 450,000 lives.
Pension Benefits
The 1199SEIU pension funds serve over 200,000 members — primarily in New York City and its Long Island and northern suburbs — and remains the model for what we want to achieve for every 1199SEIU member.
Education, Training and Job Security Benefits
These benefits are aimed at helping our members earn high school, college and advanced education degrees, as well as train them for upgraded skills in a constantly changing work environment. Many members are also eligible for placement services and extended benefits if they are laid off from their jobs.
Child Care Benefits
This benefit is a unique program that helps thousands of union families by offering a broad menu of programs for our children from birth through college — for day care and after school care, mentoring, camps, holiday programs and other activities.
Home Mortgage & Financial Wellness Programs
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- Physician Fee Schedule
- Local Coverage Determination
- Medically Unlikely Edits
- Burden Reduction
- Interoperability
- Administrative Simplification
Coordination of Benefits
Under HIPAA , HHS adopted standards for electronic transactions, including for coordination of benefits.
The coordination of benefits transaction is the transmission from any entity to a health plan for the purpose of determining the relative payment responsibilities of a health plan for health care claims or payment information. See the Coordination of Benefits Transactions Basics.
About Coordination of Benefits
Coordination of benefits (COB) applies to a person who is covered by more than one health plan.
The COB regulations, as well as the HIPAA Privacy Act, permit Medicare to coordinate benefits with other health plans and payers to reduce administrative burden and enable patients to obtain payment of the maximum benefit they are allowed. The same applies in situations where Medicare is the secondary payer and a provider must file a COB claim to Medicare.
COB claims are those sent to secondary payers with claims adjudication information included from a prior or primary payer (the health plan or payer obligated to pay a claim first). These claims can be sent 1) from provider to payer to payer or 2) from provider to payer. Additional information about Medicare's COB/claims crossover process is available.
HIPAA Adopted Standards
In January 2009, HHS adopted Version 5010 of the ASC X12N 837 for coordination of benefits. For more information, see the official ASC X12N website.
For COB pharmacy claim transactions, HHS adopted NCPDP Telecommunications Standard Version D.0.
These standards apply to all HIPAA-covered entities , health plans, health care clearinghouses, and certain health care providers, not just those who work with Medicare or Medicaid.
Related Links
- Coordination of Benefits Transactions Basics
- National Council for Prescription Drug Programs (NCPDP)
- COB/Claims Crossover Process
1199 New England Health Care Employees Welfare & Pension Funds
Download Forms
Connecticut Withholding Certificate for Pension or Annuity Payments CT-W4P
IRS Withholding Certificate for Pension or Annuity Payments W-4P
Welfare Fund Summary Plan Description
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COMMENTS
Child Care and Youth Services. View Forms by Fund. National Benefit Fund. National Benefit Fund for Rochester Members. Greater New York. Greater New York for New Jersey. Home Care Benefit Fund. Licensed Practical Nurses. Former 144 Hospital Division.
1199SEIU Benefit Funds Member Eligibility, PO Box 1035 • New York, NY 10108-1035 • Tel: (646) 473-9200 • Outside NYC area codes: (800) 575-7771 • www.1199SEIUBenefits.org ... This Coordination of Benefits Form for Spouse Coverage is for Fund use only, and will not be released to any third party except where necessary for the ...
The 1199 pension is determined by a formula [base pay] x [years of service] x [1.60%]. Upon retirement, you should receive any NYPQ pension that you earned while the NYPQ plan was in effect, and that will be dispersed according to that plan's rules. If NYPQ 1199 RNs join the 1199 National Pension Fund, NYPQ will begin making
Health Benefits. More than 200,000 members of 1199SEIU have won comprehensive healthcare coverage — hospitalization, doctors' visits, dental and vision care, prescription drugs, etc. — with no or minimal out-of-pocket expenses for themselves and their families. In all, the benefit covers more than 450,000 lives.
• Coordination of Benefits (COB) Form *(needed only if you are adding dependents) • How your Benefit Level Changes • Benefit Coverage Chart. In order to expedite your enrollment, you must fill out your forms completely and provide ... second job with another 1199 employer provide the same information). List your previous Employment in the ...
A. The SPDs of the 1199SEIU National Benefit Fund for Health and Human Service Employees and the 1199SEIU Greater New York Benefit Fund (New York plan) (the "Funds") shall be modified to include the following provisions: For Retirees otherwise eligible for the Benefit Funds' Medicare Advantage (MA) Plan, their enrollment in the MA Plan ...
Limited Distribution Specialty Drug List. covered prescriptions formulary drugs medications accredo acredo. Allergy Benefit Extension Request. Appendix B: Laboratory Guideline to Approved In-Office Laboratory Tests. provider manual clia tests in office in-office labs. Benefit Fund Appeal Representation Authorization Form.
Coordination of benefits (COB) allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more than one plan).
Your SEIU District 1199 Membership Card. Members of SEIU District 1199 benefits can be accessed here. Popular Discounts: Local takeout and fast food discounts, grocery coupons, 20% off Advance Auto Parts, $20 off tax preparation. If you can't find your card, you can always email the Member Resource Center at [email protected] or call us at 1 ...
Mail your information to: Bloomington, MN 55425-1289. www.healthpartners.com. HealthPartners P.O. Box 1289 Minneapolis, MN 55440-1289. If you have any questions about Coordination of Benefits or this form, please call HealthPartners Member Services: 952-883-5000 or 1-800-883-2177.
Under HIPAA, HHS adopted standards for electronic transactions, including for coordination of benefits.The coordination of benefits transaction is the transmission from any entity to a health plan for the purpose of determining the relative payment responsibilities of a health plan for health care claims or payment information. See the Coordination of Benefits Transactions Basics.
Download Forms. Connecticut Withholding Certificate for Pension or Annuity Payments CT-W4P. IRS Withholding Certificate for Pension or Annuity Payments W-4P. Direct Electronic Deposit Authorization. Welfare & Pension Combined Enrollment Form. Welcome to the New England Health Care Employees Welfare Fund Benefit Plan. Special Enrollment for ...
Membership Application for Download. COPE/PAC Card for download. File a Grievance (State Members Only) Delegate Nomination form (State Chapter Only) Grievance Form - Step 2. Grievance Form - Step 3 - Brightspring/Rescare. Grievance Withdrawal Form. Mercy Health Assignment Despite Objection Form. Assignment Despite Objection (RNs Only)
Coordination of benefits allows two insurance carriers to determine their fair share of the cost for covered services. Your out-of-pocket cost for services is limited to the amount, if any, that remains unpaid by the insurers. Covered services refers to the medical care, equipment, services, or prescription drugs the insurers include in their ...
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Frequently Asked Questions - Coordination of Benefits. (212) 417-4778 or visit www.ceitraining.org. CEI Line: 866-637-2342. a toll-free number for clinicians in NYS to discuss PEP, PrEP, HIV, HCV & STD management with a specialist. This line supports inquiries from clinicians only (MD, NP, PA, RN, PharmD or DDS) and is not intended for patient ...
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