Jane Dotson
1199SEIU is a health-care union that offers its members unparalleled health coverage with little to no out-of-pocket costs. In 2022, the state of New York offered taxpayer-funded health coverage to 1199 members through the Essential Plan. This plan is usually only available to those without access to employer-sponsored coverage. The deal was made to boost the 1199SEIU National Benefit Fund for Home Care Employees, which had been running a deficit. This arrangement means that 1199 members can access Medicaid, Child Health Plus, and other health plans.
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What You'll Learn
1199SEIU members' health coverage
1199SEIU members enjoy comprehensive health coverage with little to no out-of-pocket costs. This includes hospitalization, doctors' visits, dental and vision care, and prescription drugs. The benefits extend to the members' families, covering more than 450,000 lives in total.
The 1199SEIU pension funds serve over 200,000 members, primarily in New York City and its surrounding areas. Members are covered through one of the six benefit funds, each with its own eligibility requirements and level of benefits. The six benefit funds are the National Benefit Fund, the Greater New York Benefit Fund, and the Home Care Benefit Fund, as well as three unspecified others.
Members of the National Benefit Fund, Greater New York Benefit Fund, or Home Care Benefit Fund who require medical attention can access providers by telephone, avoiding transportation and waiting rooms. This includes phone visits with 1199SEIU providers for all medical and mental health services, including COVID-19-related services.
In addition to health coverage, the 1199SEIU also provides benefits such as educational assistance and placement services for members who are laid off from their jobs. The union has also been active in advocating for its members' interests, including lobbying for legislation to meet the growing need for homecare workers in Washington, D.C., and urging the protection of immigrant communities.
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Medicaid, Child Health Plus, Essential Plan
Medicaid is a health insurance plan offered by the state of New York. Children who are residents of New York State and are under the age of 19 can be eligible for Children's Medicaid. Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income. Children from families with lower incomes are not required to pay a monthly premium. For families with larger incomes, the monthly fee is capped at three children.
Child Health Plus is also a health insurance plan offered by the state of New York. It is available for children under the age of 19 who are residents of New York State and are not eligible for Children's Medicaid. There is no monthly premium for families with lower incomes, and there are no co-payments or annual deductibles. Families with higher incomes may be required to pay a monthly premium of $15, $30, $45, or $60 per child per month, depending on their income and family size.
The Essential Plan is another health insurance plan offered by the state of New York. It is available to individuals and families who do not qualify for Medicaid or Child Health Plus. The Essential Plan offers comprehensive health coverage, including hospital stays, doctor visits, prescription drugs, mental health services, and more.
To apply for any of these health insurance plans, individuals can visit the NY State of Health website or call 1-855-355-5777. They can also speak with a customer service professional by phone, Monday through Friday from 8 am to 8 pm, and Saturday from 9 am to 1 pm.
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$16.62 $19.95
1199-affiliated benefit funds
1199SEIU is a union that provides its members with access to healthcare coverage, pension funds, and other benefits. The 1199SEIU pension funds serve over 200,000 members, primarily in New York City, Long Island, and the northern suburbs. The union's goal is to eventually bring all of its members to this level of benefits.
The 1199SEIU National Benefit Fund for Hospital and Human Service Employees is a Voluntary Employees' Beneficiary Association (VEBA) that is not affiliated with any national, regional, or geographic grouping of organizations. The fund is headquartered in New York and serves more than 450,000 lives, including members' families.
Most 1199SEIU members enjoy comprehensive health coverage with little to no out-of-pocket costs, while others pay modest co-pays and premiums for high-quality care. The benefits include hospitalization, doctors' visits, dental and vision care, and prescription drugs. Additionally, the union offers benefits that help members and their families with education and training, as well as placement services and extended benefits if they are laid off from their jobs.
The 1199SEIU also provides support for members in other ways, such as lobbying for legislation that will help meet the growing need for homecare workers and speaking out about the real-world consequences of deep cuts to Medicaid.
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Taxpayer-funded health coverage
In the context of the US healthcare system, taxpayer-funded health coverage refers to the significant portion of healthcare expenditures that are financed through taxes. While the US healthcare system is predominantly private, taxpayers contribute substantially to healthcare funding, with government expenditures expected to account for more than two-thirds of national health spending by 2024. This proportion is similar to that of Canada, where government spending, excluding tax subsidies for supplemental private coverage, accounts for 70.7% of healthcare costs.
The public share of healthcare funding in the US has increased significantly over time. After correcting for differences in estimation methods, the public share of health spending rose from approximately 31% in 1965 (before Medicare and Medicaid) to about 56% in 1980, 60% in 1999, and 64.3% in 2013. By 2024, it is projected to increase further to 67.1% of national health expenditures, totaling $3.642 trillion.
Additionally, taxpayers fund health coverage through the Premium Tax Credit, which helps eligible individuals and families afford health insurance purchased through the Health Insurance Marketplace. This credit lowers the out-of-pocket cost of health insurance premiums for those who are not covered by an eligible employer-sponsored plan or a government program like Medicaid or Medicare. When enrolling in the Marketplace, individuals can determine their eligibility for advance payments of the Premium Tax Credit, which are made directly to their insurance company.
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1199 members' health insurance
1199SEIU members are eligible for health benefits once they have worked for a contributing employer for a specified period. The eligibility criteria vary, with some sources stating it to be 90 days or more, while others mention 100 hours or more per month for two consecutive months. Once eligible, members can choose between Plan A: Home Care Employees Plan A – Member Choice Home Care Select or Plan B: Home Care Employees Plan B – Panel Provider Plan.
Most 1199SEIU members enjoy comprehensive health coverage with minimal out-of-pocket expenses. The level of benefits and eligibility requirements differ across the six benefit funds. These include the National Benefit Fund, the Greater New York Benefit Fund, and the Home Care Benefit Fund. Members can access a wide range of providers by telephone, avoiding transportation and waiting rooms. This includes coverage for medical and mental health services, including those related to COVID-19.
For those seeking to enrol in health insurance, 1199SEIU provides support through a dedicated Outreach Coordinator. They can assist with queries related to Medicaid, Child Health Plus, the Essential Plan, and Qualified Health Plans through NY State of Health.
Additionally, 1199SEIU retirees who are eligible for health benefits are also covered through one of the six benefit funds, ensuring continued access to quality healthcare even after their retirement.
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Frequently asked questions
1199SEIU is a health-care union that offers its members unparalleled health coverage with little to no out-of-pocket costs.
Medicaid is government-funded health coverage for those who cannot afford it, whereas 1199 insurance is a union-provided health benefit for its members.
Yes, as an 1199SEIU member, you can apply for Medicaid, Child Health Plus, the Essential Plan, and Qualified Health Plans through NY State of Health.
You can enrol in 1199 insurance by phone or in person by scheduling an appointment with your dedicated Outreach Coordinator.
1199 insurance offers its members high-quality health coverage with little to no out-of-pocket costs, as well as access to a network of providers by telephone to avoid transportation and waiting rooms.
