Enrollment

Enroll for Benefits

You must enroll in person at our Central Administration office (305 W. 44th Street, Manhattan) before you or your dependents are eligible for health benefits.

Not all members are eligible for all benefits.

Required Documents

• Photo ID

Members must show a valid, original driver's license or state ID with photo.

• Social Security Card

• Marriage Certificate

An original marriage certificate must be shown to enroll your spouse. This is in addition to an original Social Security Card.

• Birth Certificate

An original birth certificate or original adoption papers must be shown to enroll each child. This is in addition to an original Social Security Card.

• Proof of Address

Hospital Card

After you enroll for benefits, you will receive a hospital/healthcare ID card in the mail. This card identifies your hospital insurer and states the type of plan you are covered under. Always carry your hospital/healthcare ID card in case of emergencies or hospital admissions.

See more about hospital coverage.

Dependents

Dependents must be enrolled in person at our Central Administration office.

Newborns

Newborns may be enrolled at either one of our Health Centers or Central Administration. Their original birth certificate still must be shown at the time of enrollment. In order to maintain continuous coverage, newborns should be enrolled within 30 days of birth.

As an eligible member or Hotel Industry Retiree, your covered dependents may include:

• Your spouse

• Your children

Children are covered until they reach age twenty-six unless they have other employer-sponsored health coverage available except through either parent.

• Your stepchildren and adopted children

This includes children legally placed for adoption. Stepchildren and adopted children are also covered until they reach age twenty-six unless they have other employer-sponsored health coverage available except through either parent.

• Your disabled children

Regardless of age, disabled children who are unable to support themselves due to mental illness, developmental disability, mental retardation or physical handicap as defined in the New York Mental Hygiene Law, may be covered. They must have been incapacitated before reaching age nineteen and remain unmarried.

• Your newborn grandchildren

Eligible grandchildren -- which are children born to unmarried eligible dependents of a covered employee, eligible spouse, retiree, or domestic partner -- receive coverage for thirty days from birth. Separate arrangements outside of the Health Benefits Fund must be made to continue coverage for the grandchild beyond that time.

• Your domestic partner and their dependent children

See the domestic partner requirements, which include a 90-day waiting period.

Upon first certifying as domestic partners, your qualified domestic partner and his or her dependent children will be eligible for health benefits no earlier than ninety days following the date this document is completed and presented to the Fund office.

For continued coverage, you and your qualified domestic partner must recertify and file a new Domestic Partnership Affidavit with all required documentation every twelve months. As long as you recertify by this annual deadline, there will be no additional waiting period for renewed eligibility.

If you do not recertify by your annual deadline, your domestic partner and his or her dependent children will lose health coverage until you again certify your domestic partnership status.

You can have only one qualified domestic partner or one spouse active on your health plan at a time.

Health benefit coverage for qualified domestic partners and their dependents will respectively match health benefits provided to spouses and dependents. Qualified domestic partners and their dependents are also subject to the same Plan rules stated in this Summary Plan Description.

Other benefits, such as Pre-Paid Legal, Industry Training Program and Scholarship are not available to domestic partners or children of domestic partners.

Domestic partners are not considered “qualified beneficiaries” under the federal COBRA laws and therefore will have no right under the law for continued self-pay benefits after a “qualifying event” which causes loss of health coverage.

The covered member must notify the Central Administration office within fifteen days of any change in status as domestic partners which would change eligibility for Fund benefits. Upon termination of domestic partner status, the covered member must also submit a Statement of Domestic Partnership Termination (included on last page) to the Fund Office and mail a copy to the domestic partner within the same fifteen-day timeframe.

Qualified domestic partners must prove that they have resided together and been financially interdependent for at least six months prior to the submission of this affidavit. Any dependent children being enrolled for coverage have also met this residency and financial interdependence requirement.

Divorce

If you divorce, your spouse will lose coverage for benefits unless a court order states otherwise. However, your spouse has the option to continue health coverage through COBRA for up to thirty-six months.

Within thirty days of a divorce, you must provide a court-ordered final decree granting divorce to the Central Administration office.

After a divorce, you should review your choices for life-insurance beneficiaries that we have on file.

Your Children

Your divorce settlement may name who will provide health coverage for your children. Alternately, you may be required to provide coverage for your children under federal law. A Qualified Medical Child Support Order (QMCSO) may require the Health Benefits Fund to provide coverage for your children.

After a divorce, a Qualified Medical Child Support Order (QMCSO) may require the Health Benefits Fund to provide coverage for your children when you and your spouse divorce.

The process begins when the Central Administration office receives a QMCSO. This means any judgment, decree, or order, including approval of a settlement agreement, which:

• • Is issued by or from a court under state domestic relations law.
  • Requires an employee to provide the group health coverage available under the Fund for his or her children, even though he or she no longer has custody of them.
  • Clearly specifies:

Please note, a child’s custodial parent, legal guardian or a state agency may apply for Fund coverage of an employee’s children, even if you as the employee do not. The Fund Office or your Employer will provide written notification to you and each identified child that it has received a court order requiring coverage.

The Fund will comply with a QMCSO issued by a judge or a National Medical Support Order (NMSO) issued by a state agency which meets the requirements of a QMCSO. These types of orders require the Fund to provide medical coverage for the child of a member who does not have custody of that child.

If a QMCSO or a NMSO is received, the Fund Office or your Employer will provide written notification to you and each child of his or her eligibility for coverage and will permit immediate enrollment. This notice will include any required enrollment material, a description of the procedures to be followed and a form for designating the child’s custodial parent or legal guardian as his or her representative for all purposes. Contact the Central Administration Office for more information.

Further Information

See Frequently Asked Questions for information about making changes to your enrollment and other topics.

Acceptable Birth Certificates
The member, enrolled spouse or domestic partner must appear on a child’s birth certificate in order to enroll a dependent child. For children of domestic partners, the dependent may be the biological or legal child of the domestic partner in order to enroll the dependent. A court order is required in the case of adoption or a Qualified Medical Child Support Order (QMCSO). If a birth certificate is in a language other than English, the member is responsible for having the birth certificate translated and notarized.

Dual-Eligible Enrollees
Some people may be eligible for benefits through more than one enrollment, such as in these scenarios:

• A member who is eligible as a spouse of another member
• A member who is also eligible as a dependent of another member
• A child who is eligible as a dependent of two eligible members

In these cases, it’s in your best interest for each dual-eligible person to be enrolled for benefits in each scenario. This will ensure that if you lose eligibility under one scenario you may still be eligible under another.

Note that dual-eligibility does not entitle a person to doubling or “additive” benefits. Using the above example, if John receives eye glasses once per twelve-month period, he cannot combine his vision benefit as a spouse in order to double benefit.

Foreign Documents
Documents originating in another country must be certified and translated by that country's consulate.

Foreign Consular Offices in the United States.

Removing/Disenrolling Dependents
See Can I Remove a Dependent from My Coverage? in the FAQ.

Eligibility »