Service Employees 32BJ North Health Fund

Tri-State Preferred North Summary Plan Description (SPD) >> Plan Facts

This booklet is the Summary Plan Description (SPD) of the plan of benefits (the Plan) of the Service Employees 32BJ North Health Benefit Fund (the Fund) with regard to the Hospital, Medical, Prescription Drug, Employee Assistance Program, Dental, Vision, Short-term Disability, and Retiree Health Benefits of the Tri-State Preferred North Plan. Your Life Insurance and Accidental Death and Personal Loss Coverage benefits are insured by Aetna Life Insurance Company and are summarized in the enclosed materials provided by Aetna.

Plan Name:
Service Employees BJ North Health Benefit Fund
Employer Identification Number: -
Plan Number: 501
Plan Year: January 1 – December 31
Type of Plan: Welfare Plan

Funding of Benefets and Type of Administration

Self funded, except MHN insures the EAP benefit, Aetna insures the Life and Accidental Death & Personal Loss Coverage benefits and the First Rehabilitation Life Insurance Company of America insures the short-term disability benefit. All contributions to the Trust Fund are made by contributing employers under the Plan in accordance with their written agreements. Benefits are administered by the organizations listed in the "Contact Information" section.

Plan Sponsor and Administrator

The Plan is administered by a joint Board of Trustees consisting of Union Trustees and Employer Trustees. The office of the Board may be contacted at:

Board of Trustees
Service Employees BJ North Health Benefit Fund
140 Huguenot Street
New Rochelle, NY 10801

Participating Employers

The Fund Office will provide you, upon written request, with information as to whether a particular employer is contributing to the Plan on behalf of employees working under a written agreement, as well as the address of such employer. Additionally, a complete list of contributing employers and unions sponsoring the Plan may be obtained upon written request to the Fund Office and is available for examination at the Fund Office.

To contact the Fund Office, write to:

Fund Office
Service Employees BJ North Health Benefit Fund
140 Huguenot Street
New Rochelle, NY 10801

To contact the Health Fund, call:

1-914-637-7000

or write to:

Service Employees BJ North Health Benefit Fund
140 Huguenot Street,
New Rochelle, NY 10801

Agent for Service of Legal Process

The Board has been designated as the agent for the service of legal process. Legal process may be served at the Fund Office or on the individual Trustees. For disputes arising under the portion of the Plan insured by Aetna, service of legal process may be made upon Aetna at their local offices or upon the supervisory official of the Insurance Department of the state in which you reside. For disputes arising under the portion of the Plan insured by MHN, service of legal process may be made upon MHN, 1600 Los Gamos Drive, Suite 300, San Rafael, CA 94903-1807.