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Seiu local 1 2 claim form 2026

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The document is a Medical Claim Form for the SEIU Locals 1 & 2 Benefit Trust Fund, specifically for members of the Justice for Janitors policy. It includes sections for member and dependent information, details about the medical expenses incurred, and authorizations for processing claims. The form requires personal information and signatures to ensure confidentiality and compliance with health care regulations.

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Click ‘Get Form’ to open the SEIU Local 1 2 Claim Form in the editor.
Begin by entering your personal information in the designated fields, including your first, middle, and last name, as well as your address and date of birth.
Indicate whether this is an initial or subsequent claim and provide details for any dependents if applicable. Ensure you fill in their names and dates of birth accurately.
In the expense section, specify the type of expense incurred, including the name or D.I.N. of the drug supplier or pharmacy, along with the amount charged.
Answer whether you have any other coverage that would pay a benefit for this claim by selecting 'Yes' or 'No'.
Review the authorization statement carefully before signing. This confirms that you allow Global Benefits to process your claim using your personal information.
Finally, add your signature and date at the bottom of the form before submitting it to Global Benefits via email or fax.

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What is the SEIU Local 1?

Local 1 is the founding Local of the Service Employees International Union (SEIU) and was started in Chicago in 1921 by Residential Maintenance Workers. Throughout our long history, Local 1 members have fought together to raise and maintain high labor standards for Property Service Workers everywhere.

What does SEIU local stand for?

Normal Retirement. Age 65 or, if later, 60 months after the first contributions were made for you. Termination Under age of 65, you will need to wait until the end of the Plan year in which you terminate employment, plus an additional month. A single lump-sum distribution at or after normal retirement (age 65)

Who does SEIU Local 1 represent?

SEIU Local 1 represents more than 3,000 security officers, janitors and arena workers throughout Michigan primarily in the city of Detroit.

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What are the benefits of SEIU Local 1?

We are the Service Employees International Union (SEIU), an organization of 2 million members united by the belief in the dignity and worth of workers and the services they provide and dedicated to improving the lives of workers and their families and creating a more just and humane society.

What is the phone number for SEIU local 1 benefits?

Call: (877)233-8880 or (312)233-8880 Email: mrc@seiu1.org. If you would like to contact the Member Resource Center please call (877)233-8880 or (312)233-8880 or fill out the form below and someone will get back to you shortly.

Seiu local 1 2 claim form 2026

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