SOCIAL SERVICE EMPLOYEES UNION LOCAL 371 ADMINISTRATIVE FUND

Allows dual-member couples to access each other's dental, optical, hearing aid, abortion, and prosthetic appliance benefits through Special Coordination of Benefits (SCOB), maximizing combined benefit utilization.

Pays administrative expenses necessary to operate the union's benefit plans, supporting the ongoing functionality of health, dental, life insurance, and disability programs.

Requires timely filing of claims (within 60 days for disability and dental, one year for other benefits), provides a 60-day window to appeal denied claims, issues written decisions with rationale, and allows members to request a conference with a Board committee if an appeal is rejected.

Offsets future benefits to recover overpayments when members fail to repay mistakenly issued funds, ensuring financial accountability of the benefit system.

Offers COBRA continuation coverage for prescription drug, dental, optical, hearing aid, podiatry, abortion, and prosthetic appliance benefits for up to 18 months after qualifying events, extendable to 36 months, with an additional 11-month extension (total 29 months) for those deemed disabled by Social Security.

Provides access to covered dental services at the SSEU Local 371 Dental Facility, LLC, with up to $2,000 in annual benefits per patient ($4,000 for dual-member couples); requires pre-authorization for major procedures; allows reimbursement for non-participating dentists; and increased Invisalign lifetime maximum to $2,000 for members and dependents aged 19 and over effective May 2021.

Pays disability benefits at a rate of $200 per week for up to 34 weeks within a 24-month period; provides maternity disability benefits for up to eight weeks (ten weeks for Cesarean delivery); and allows continuation of other Welfare Fund benefits for up to six additional months after disability benefit exhaustion if the member remains disabled.

Provides $10,000 in group life insurance benefits to designated beneficiaries upon the death of a covered member; continues coverage at no cost for members who become totally disabled before age 60 and allows conversion to individual policies without a medical exam if eligibility is lost.

Provides a dedicated contact number for the SSEU Local 371 Dental Facility to clarify affiliation and direct member inquiries, improving accessibility and communication for benefit-related questions.

Provides full optical benefits including eye exams, lenses, and frames every 24 months for members and spouses/domestic partners, and every 12 months for dependent children; offers a no-expense package valued at $225 (adults) or $150 (children); reimburses up to $125 per adult and $75 per child for non-participating providers; allows dual-member couples to access two full benefits.

Provides a $10,000 accidental death benefit in addition to standard life insurance proceeds, and offers $10,000 for dismemberment or loss of sight (e.g., both hands, both feet, or both eyes), or $5,000 for the loss of one hand, one foot, or one eye.

Provides a $500 benefit toward funeral expenses for deceased Fund members.

Collects employer contributions pursuant to a collective bargaining agreement with the City of New York and remits them to the union's benefit plans, ensuring funding continuity for member benefits.

Increased educational course benefits from $600 to $700 and organization fees from $100 to $200 per academic year for members; provides scholarships through the Charles Ensley Scholarship Foundation for union members and their children attending the School of Labor & Urban Studies at CUNY.

Offers one-on-one pension counseling sessions to covered members regardless of retirement timeline, conducted in-person or by phone, with preparatory letters outlining required documentation and personalized guidance on retirement and beneficiary benefits.

Provides prescription drug coverage with a maximum of $500 per 30-day supply at retail pharmacies and $1,500 per 90-day supply via mail order; offers enhanced coverage for dual-member households up to $1,000/$3,000; operates a hardship appeal program for waiver of limits; and provides access to injectable and chemotherapy medications through the PICA program.