SEIU Local 2000

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ELIGIBILITY
Not all members are eligible for all benefits. You should check with the Fund office before making any decisions based on the information provided on this website.

Eligibility Requirements for Spouse / Dependent coverage
Order of Benefits Determination

The following forms may be downloaded for your convenience, print, fill and mail back to our office:
Health and Welfare Elegibility status change and/or disenrollment form

COBRA
If your coverage ends, you and your dependents may continue your medical and/or dental benefits for a specific period of time by self-paying the premium.

COBRA Enrollment Form
Rights and obligations under the continuation coverage provisions
Group Health Continuation Coverage
Qualifying Events and Coverage Period
Terminations of continuation Coverage

HIPPA
Creditable Coverage
Under a new federal law, known as the Health Insurance Portability and Accountability Act of 1996, you are entitled to a Certificate of Health Coverage upon your eligibility for COBRA continuation coverage or, if not eligible for COBRA continuation coverage, upon your losing coverage under a group health plan.

In the event you need to provide evidence of prior health insurance coverage, you may use the information on your Certificate to reduce or eliminate a preexisting condition exclusion period with another health insurance carrier.

Request for Certificate
Please call the Fund office and speak to Catherine D. Tipton at extension 33 or
email to her at tiptonc2000@mindspring.com to request a Certificate.