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1199SEIU Benefit and Pension Funds 330 West 42nd Street New York, NY 10036-6977 www.1199SEIUBenefits.org ADDRESS SERVICE REQUESTED

Non-Profit Org. U.S. POSTAGE PAID New York, NY Permit No. 3700

DEDICATED TO THE HEALTH & WELL-BEING OF 1199SEIU MEMBERS

FALL 2010

For Your Benefit

A Magazine Devoted to the Health & Well-Being of 1199SEIU Members EN ESPAÑOL p12

Finding a healthier way to live! SAVOR Fall’s Seasonal Fruits and Vegetables New HEALTH Law Brings Changes

Step therapy is designed to provide safe, effective treatment while controlling prescription costs. With step therapy, you are required to try established, lower-cost, clinically appropriate alternatives before progressing to other, more costly medications, such as preferred brand names.

MESSAGE FROM THE EXECUTIVE DIRECTOR

In this issue 3 New Healthcare Reform Law Extends Coverage for You and Your Family 4 Avoid Long Waits at the ER 5 Your Rights Under the Women’s Health and Cancer Act 5 Get Your Flu Shot 6 Secretary-Treasurer Maria Castaneda Lost 42 Pounds and Found a Healthier Way to Live 7 Savor Fall’s Seasonal Fruits and Vegetables 8 2010 Dietary Guidelines for Americans

As an 1199SEIU member, your health benefit coverage is among the best in the country – the very kind that President Obama’s healthcare law is intended to achieve for the majority of Americans.While you already enjoy many of the benefits – and more – that the new law offers, there are some changes ahead for 1199SEIU members beginning in January 2011. In this issue of your member magazine, For Your Benefit, you will read about those changes, which include extending coverage to dependent children up to age 26 and the elimination of lifetime maximum benefit limits.You will also learn how to safeguard your health – and your hard-earned benefits – by avoiding the emergency room and turning to one of our Urgent Care or Walk-In Health Centers when you need medical care but can’t reach your doctor. You will also read about the new federal Dietary Guidelines calling for Americans to reduce calories and increase exercise – and learn how to do it with help from our health workshops and discounted gym memberships. And 1199SEIU’s very own Secretary-Treasurer, Maria Castaneda, will inspire you with her story of how making a commitment to break bad habits and replace them with healthy new ones helped her shed more than 40 pounds.You can even get started on achieving your own health goals by signing up for the Nutrition Workshop on October 9 at the Funds’ New York headquarters!

10 Walking Yourself to Better Health

So be sure to take full advantage of all the benefits your Funds offer. And as always, we hope you find the news in your member magazine helpful and informative.

11 Nurse Helpline Provides 24-Hour Support

Sincerely,

PROTECT YOUR CARD Your Health Benefits ID card is for your use only. Do not leave your card with your pharmacist. Show it to the pharmacist when ordering your prescription and make sure it is returned to you before you leave the store. If your card is lost or stolen, immediately report it to the Benefit Fund at (646) 473-9200. If you think someone is fraudulently using your card, call the Benefit Fund's hotline at (646) 473-6148 or visit our website at www.1199SEIUBenefits.org. USE A PARTICIPATING PHARMACY For a listing of Participating Pharmacies, call the Benefit Fund’s Member Services Department at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org. If you use a Non-Participating Pharmacy, you will have to: • Pay for your prescription when it is filled; • Call the Benefit Fund’s Member Services Department for a Prescription Reimbursement Claim Form; and • Complete this form and send it along with an itemized paid receipt for your prescription to the address indicated on the form.

choice of address. If you live in New York or New Jersey, you may choose to order and pick up your 90-day supply at a designated participating pharmacy. If you are currently taking a maintenance medication, ask your doctor for a 90-day prescription (with 3 refills) and fill it either by: • Mailing the prescription to the Benefit Fund’s mail order pharmacy, where it will normally be delivered within eight days; or • Taking it to one of the designated pharmacies in New York or New Jersey. For new maintenance medications, ask your doctor for two prescriptions: one for a 30-day supply (with one refill) and another for a 90-day supply (with 3 refills) that can be filled through the maintenance drug access program once you know that the medication works for you. Call the Benefit Fund at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org for the locations of pharmacies that participate in the maintenance drug access program, for a mail order form or to determine if the drug that you are taking is a maintenance medication. COORDINATING PRESCRIPTION DRUG BENEFITS If your spouse is covered for prescription medication under another healthcare plan, that plan is primary. The Benefit Fund is the secondary plan for your spouse and may provide coverage for any co-payments or deductibles that your spouse may incur up to the Benefit Fund’s Schedule of Allowances.

Although your spouse’s name will appear on your Health Benefits ID card, he or she must use their primary prescription insurer first. Participating Pharmacies will not fill prescriptions for your spouse through the use of this Health Benefits ID card. WHAT’S NOT COVERED The Benefit Fund does not cover: • Over-the-counter drugs (except for diabetic supplies); • Over-the-counter vitamins; • Non-prescription items such as bandages or heating pads — even if your physician recommends them; • Prescriptions for drugs not approved by the FDA for the treatment of your condition; • Cost differentials for drugs that are not approved through the Benefit Fund’s Prescription Drug Program; • Experimental drugs;

11 Staying Healthy Is Fun When It’s a Family Affair Mitra Behroozi Executive Director 1199SEIU Benefit and Pension Funds

The Fund believes it is a "grandfathered health plan" under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that this plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for an external review process for claims appeals. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

PA R A S U B E N E F I C I O

**This may include contributions for severance or other wages paid to you, such as vacation, etc. Effective December 3, 2009, Section II. L is hereby replaced with the following: Section II.L PRESCRIPTION DRUGS BENEFIT BRIEF Prescription Drugs • Coverage of FDA-approved prescription medications for FDA-approved indications, except plan exclusions • No co-payments, no deductible when you use generic drugs and preferred drugs where available • Use Participating Pharmacies • Mandatory maintenance drug access program • You must comply with the Benefit Fund’s Prescription Programs. For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Wage Class I: Family Wage Class II: Not Covered Wage Class III: Not Covered If you are in Wage Class I, you, your spouse and your children are covered for prescription drugs. If you are in Wage Class II or Wage Class III, you are not covered for this benefit. WHAT IS COVERED The Benefit Fund covers drugs approved by the Food and Drug Administration (FDA) that: • Have been approved for treating your specific condition; • Have been prescribed by a licensed prescriber; and • Are filled by a licensed pharmacist.

same quantities and be the same strength as the corresponding brand-name drug. Most importantly, they must meet the same FDA standards for safety and effectiveness. When your doctor gives you a prescription: • If there is a generic equivalent for a brand-name drug, you must get the generic drug. Otherwise, you will have to pay the difference in cost between the brand-name drug and the generic equivalent. • If there is no generic equivalent, your prescription will be filled with the brand-name drug. • In rare situations, your doctor may specify the brand-name drug. In this case, your doctor must submit detailed medical information and supporting documentation to the Prescription Review Department to evaluate the clinical reasons why the brand-name drug is necessary. Preferred Drugs The Benefit Fund and its Pharmacy Benefit Manager have developed a list of preferred drugs known as a Preferred Drug List (PDL). Drugs were selected based on how well they work and their safety. All participating providers have been provided with a copy of the Preferred Drug List. It should be used when prescription medication is required. If your doctor prescribes a brand-name drug that is not preferred, you will have to pay the difference in cost between the preferred drug and the non-preferred drug. If you would like a copy of the PDL, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org. Prior Authorization for Specified Medications You must get prior approval before benefits can be provided for prescriptions filled with certain medications. The Plan Administrator will periodically publish an updated listing of which drugs require prior authorization. If your doctor prescribes any of those drugs, contact the Prior Authorization Department of the Benefit Fund at (646)473-9200. Some drugs require prior authorization from the Pharmacy Benefit Manager. Visit our website at www.1199SEIUBenefits.org for a comprehensive list and the correct phone number to use. NOTE: You may have to pay the entire cost of the prescription if you don't get prior approval from the Benefit Fund. These claims will not be reimbursed. Quantity and Day Supply Limits

Benefits for prescriptions for FDA-approved drugs that are not approved for treatment of your condition must be submitted to the Benefit Fund office for consideration. Your doctor should provide detailed medical information and supporting documentation for prescribing this medication. USING YOUR BENEFITS To get your prescription: • Ask your doctor to prescribe only covered medications, as per the Benefit Fund’s Prescription Programs; • Use Participating Pharmacies for short-term medications; and • Show your Health Benefits ID Card to the pharmacist when you give him or her your prescription. There is no out-of-pocket cost for your prescriptions if you comply with the Benefit Fund’s prescription programs: • Mandatory generic drug program; • Preferred Drug List; • Mandatory maintenance drug access program; • Prior authorization for specified medications; • Quantity and day supply limitations; • Step therapy; and • Use the Specialty Care Pharmacy for injectables and other drugs that require special handling. PRESCRIPTION DRUG PROGRAMS For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Generic Drugs Generic Drugs are the same as brand-name drugs. The only major difference is the cost. By law, generic drugs must contain the same active ingredients in the

These prescription programs are intended to monitor clinical appropriateness of utilization based upon FDA guidelines. Examples of these programs are: Proton Pump Inhibitors – You must get prior approval if your doctor prescribes one of these drugs for more than a 90-day period. Migraine Medications – Coverage is limited to a specific quantity. Prescriptions for these medications must be in compliance with the standards and criteria established by the FDA and accepted clinical guidelines for standard of care. Dose Optimization – a program to help members have a more convenient "once per day" prescription dosing regimen whereby prescriptions written for twice-a-day dosing may be changed to once-a-day dosing. Personalized Medicine – is a voluntary program to members using drugs like Tamoxifen and Warfarin to help the physician determine which drug and dosage are clinically appropriate. Quantity Duration – based on FDA recommended prescribing and safety information, the quantity duration rules helps members receive the most clinically effective dosages of medication. Specialty Care Members must use the Specialty Care Pharmacy Program for injectables and other drugs that require special handling. Call the Benefit Fund or visit our website at www.1199SEIUBenefits.org for a listing of drugs included in this program. Specialty Care drugs are available only through this mail delivery service. Biotechnology Drugs The Benefit Fund’s payments for pharmacy benefits for medically necessary treatment are limited to $100,000 for biotechnology drugs. No additional benefits for biotechnology

New Health Reform Law Extends Coverage for You and Your Family President Obama’s new health reform law, also known as the Patient Protection and Affordable Care Act, means good news for the nation and good news for you and your family. In our last issue, we told you that some changes would probably not take place until the next collective bargaining agreement because the standard legal practice with most legislative changes has been to wait until after the expiration of the CBA. However, the Obama administration would like to see many of their new provisions implemented as soon as possible to ensure that millions of Americans get the care they need. In fact, major provisions affecting commercial insurers, such as prohibiting discrimination against those with pre-existing conditions, are now already in effect. (While the Fund has never dropped or denied coverage to any member or dependent, we have all heard the horror stories about insurance companies and HMOs regularly denying coverage to those most in need!)

Dependent Coverage up to Age 26 While the Benefit Fund has covered dependent children up to age 23 if they are in school, the new law requires dependent coverage up to age 26, regardless of student status, if they do not have employer coverage on their own. If you have a dependent child under age 26, please keep an eye out for the new enrollment forms we will send out this fall. If your spouse also has employer health coverage, the “birthday rule” will apply to determine whether your dependent is covered by the 1199SEIU Benefit Funds or your spouse’s health plan.

Who is eligible and considered a dependent child? Your biological or legally adopted children are covered (coverage for legally adopted children starts from placement). Stepchildren, foster children and grandchildren are not covered by the Fund. Children of your domestic partner cannot be covered by the Fund unless they are legally adopted by or placed for adoption with you.

What is the birthday rule? Like any other child, if you and your spouse both have dependent coverage, your child must also enroll in your spouse’s plan. The primary payer will be the plan of the parent whose birthday is earliest in the year and the other parent’s plan is the secondary payer.

Other provisions, however – like dependent coverage up to age 26 and the elimination of lifetime maximums – are required to go into effect the first plan year beginning after September 23, 2010, which is January 1, 2011, for our Benefit Funds.The Funds will begin re-enrollment of all members and dependents later this fall to ensure that everyone who is entitled to our comprehensive benefits receives them. Please keep an eye out for the new enrollment forms we’ll be sending you.

About Your Benefits

* Effective January 1, 2010 the HealthCare Reform provisions on overaged dependents up until age 26 - discussed elsewhere in this magazine - take effect).

If you have any questions about your coverage and benefits, please contact our Member Services Department at (646) 473-9200 or talk to your Outreach Coordinator.Your Fund is here for you! Of course, the millions of dollars in cost for this new coverage was not anticipated at the time the collective bargaining agreement was negotiated last summer and so we will need to be more vigilant than ever in spending every dollar wisely and searching for new cost-savings opportunities.

Lifetime Maximum Benefits Eliminated While most members never reach the lifetime maximum benefits in our Funds, effective January 1, 2011, the National Benefit Fund will eliminate its $1,000,000 Member Choice lifetime maximum and $500,000 maximum for non-Member Choice. The Greater New York Benefit Fund’s $500,000 maximum benefit (for members in NY shops) will also be eliminated. If you have recently reached a lifetime maximum benefit, please contact Member Services at (646) 473-9200 to discuss transitional care back into the Fund.

FOR YOUR BENEFIT

• Prescriptions for drugs not approved by the FDA for the treatment of your condition; • Cost differentials for drugs that are not approved through the Benefit Fund’s Prescription Drug Program; • Experimental drugs; • Non-sedating antihistamines; • Migraine medication in excess of FDA guidelines for strength, quantity and duration; • Medications for cosmetic purposes; • Proton pump inhibitors in excess of a 90-day supply for FDA-approved indications by diagnosis; • Biotechnology drugs above the $100,000 limit; • Cold and Cough Prescription products; • Oral Erectile Dysfunction agents (except for penile functional rehabilitative therapy for up to six-months immediately following prostatic surgery); and • All general exclusions listed in Section VII.D. Some benefits may require prior authorization. Please refer to the sections describing those specific benefits for more information.

Avoid Long Waits at the ER: Use Our Benefit Funds’ Urgent Care Network According to a new report by the American College of Emergency Physicians, New Yorkers wait an average of five hours when they visit hospital emergency departments. That’s one of the longest wait times in the nation! Remember, you and your family can avoid that frustration by visiting one of our participating Urgent Care or Walk-In Health Centers when you need care quickly. Urgent Care Centers and Walk-In Health Centers offer extended hours and treat urgent but non-emergency conditions like the flu, allergic reactions, and minor injuries and burns. And the staff at an Urgent Care or Walk-In Health Center will have more time to ask you about your medical history and answer your questions than a busy ER doctor. For a list of Urgent Care and Walk-In Health Centers convenient to you, go to www.1199SEIUBenefits.org. You can also access care without leaving your home by calling the 1199SEIU Nurse Helpline or a Health Coach at (866) 935-1199 for around-the-clock support, seven days a week, for answers to your questions.

The plan sponsor of the1199SEIU National Benefit Fund for Health & Human Service Employees reserves the right to amend or terminate the 1199SEIU National Benefit Fund for Health & Human Service Employees, or any part of it, at any time. 1199SEIU GREATER NEW YORK BENEFIT FUND SUMMARY OF MATERIAL MODIFICATIONS

This Summary of Material Modifications describes changes that affect your job security benefit plan and updates the Summary Plan Description (“SPD”) that was previously distributed to you. You should keep this summary with your SPD until the SPD is updated to reflect the changes discussed herein. -----------------------------------------------------------------------------

NEW YORK CITY EMPLOYEES For New York City employees, certain classes of drugs will be covered through the health program provided to you through the City and not covered through the NBF prescription benefit. For a listing of these drugs, please contact the Benefit Fund’s Prescription Department. Effective December 11, 2008, the definitions of “domestic partner” and “spouse” in Section IX are replaced with the following: Same-sex Partner (formerly “domestic partner”) The individual with whom you are in a same sex partner relationship which meets the criteria set forth in Section 1.A. Spouse The person to whom a member is legally married and who is eligible for benefits from the Benefit Fund as described in Section 1.A. Generally, wherever the term “your spouse” is used in this booklet, it is intended to refer to your same-sex partner as well, except where noted otherwise or the context would indicate such usage was not intended. Effective September 21, 2009, the sixth bullet point in Section VII.D, “What is Not Covered,” is hereby replaced with the following: To the extent permitted by law, charges related to an illness or injury: That was deliberately self-inflicted except where such illness or injury is attributable to a mental condition, or That resulted from the person committing an illegal act

The following subsections of Section I. A of the SPD, entitled “Your Children” and “After Your Child Reaches Age 19,” are hereby replaced with the following, respectively: YOUR CHILDREN * Your children are eligible up to their 19th birthday if all the following conditions are met: They’re your biological children; or They’re your legally adopted children (coverage for legally adopted children starts from placement); or You are their legal parent identified on their birth certificate; and They are dependent on you for their full support and are living permanently with you, or an appropriate court issues a qualified medical child support order which provides otherwise (see box in Section I.A); They’re not married; and You are eligible for family coverage, based on your Eligibility Class (see Section I.D). Your stepchildren, foster children and grandchildren are not covered by the Benefit Fund. AFTER YOUR CHILD REACHES AGE 19 (effective January 1, 2010) Your child’s coverage may be continued from your child’s 19th birthday up to his or her 23rd birthday if: • He or she is a full-time matriculated student attending high school or college, not married, not working full-time, living at home or school, and totally dependent on you for support (“totally dependent”); and • You file a properly completed Dependent Recertification Form, along with proof that your child is a full-time student, with the Benefit Fund when your child turns age 19 and each year after that until your child’s 23rd birthday.

----------------------------------------------------------------------------This summary only highlights the key changes made to the 1199SEIU National Benefit Fund for Health & Human Service Employees. Summaries of material modifications together with the Summary Plan Description make up your official plan descriptions; please keep them together and refer to them as necessary. We have made every attempt to insure the accuracy of the information in this summary and the Summary Plan Description. However, if there is any discrepancy between them and the plan document, insurance contracts or other legal documents, the legal documents will always govern. If you would like to review the plan document or have any questions, please contact the Fund’s Member Services Representatives at (646) 473-9200. The Fund believes it is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your this plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for an external review process for claims appeals. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits. Questions regarding the Fund's status as a grandfathered health plan can be directed to the Fund at 646-473-9200. You may also contact the Employee Benefits Security

Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.

Your child is not a dependent if he/she: • Lives outside of the United States; or • Is in the military or similar forces of any country or subdivision thereof. EXTENSION OF COVERAGE FOR STUDENTS UNDER MICHELLE’S LAW If your totally dependent child who is enrolled full-time in high school or college takes a medically necessary leave of absence due to a serious illness or injury and the Benefit Fund has received written certification of the medical necessity by his or her treating physician, your child’s coverage may be continued for up to one year after the first day of the leave of absence or the date coverage would otherwise terminate under the terms of the Benefit Fund (if earlier) (for instance, upon your child’s 23rd birthday). Effective September 21, 2009, the first paragraph of Section I.I, “When Your Benefits Stop,” is replaced with the following: If you are no longer employed by a Contributing Employer, stop working or your employer is not obligated to make payments to the Benefit Fund on your behalf, all benefits end 30 days after the last day for which your employer is required to make contributions to the Benefit Fund* on your behalf unless your benefits are continued as described in Section I.J or Section VI- Retiree Health Benefits. * Effective January 1, 2010 the HealthCare Reform provisions on overaged dependents up

PA R A S U B E N E F I C I O

In this case, your doctor must submit detailed medical information and supporting documentation to the Prescription Review Department to evaluate the clinical reasons why the brand-name drug is necessary.

Your Health Benefits ID card is for your use only. Do not leave your card with your pharmacist. Show it to the pharmacist when ordering your prescription and make sure it is returned to you before you leave the store.

Preferred Drugs The Benefit Fund and its Pharmacy Benefit Manager have developed a list of preferred drugs known as a Preferred Drug List (PDL). Drugs were selected based on how well they work and their safety. All participating providers have been provided with a copy of the Preferred Drug List. It should be used when prescription medication is required. If your doctor prescribes a brand-name drug that is not preferred, you will have to pay the difference in cost between the preferred drug and the non-preferred drug. If you would like a copy of the PDL, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org.

If your card is lost or stolen, immediately report it to the Benefit Fund at (646) 473-9200. If you think someone is fraudulently using your card, call the Benefit Fund's hotline at (646) 473-6148 or visit our website at www.1199SEIUBenefits.org.

Prior Authorization for Specified Medications You must get prior approval before benefits can be provided for prescriptions filled with certain medications. The Plan Administrator will periodically publish an updated listing of which drugs require prior authorization. If your doctor prescribes any of those drugs, contact the Prior Authorization Department of the Benefit Fund at (646)473-9200. Some drugs require prior authorization from the Pharmacy Benefit Manager. Visit our website at www.1199SEIUBenefits.org for a comprehensive list and the correct phone number to use. NOTE: You may have to pay the entire cost of the prescription if you don't get prior approval from the Benefit Fund. These claims will not be reimbursed. Quantity and Day Supply Limits These prescription programs are intended to monitor clinical appropriateness of utilization based upon FDA guidelines. Examples of these programs are: Proton Pump Inhibitors – You must get prior approval if your doctor prescribes one of these drugs for more than a 90-day period. Migraine Medications – Coverage is limited to a specific quantity. Prescriptions for these medications must be in compliance with the standards and criteria established by the FDA and accepted clinical guidelines for standard of care. Dose Optimization – a program to help members have a more convenient "once per day" prescription dosing regimen whereby prescriptions written for twice-a-day dosing may be changed to once-a-day dosing. Personalized Medicine – is a voluntary program to members using drugs like Tamoxifen and Warfarin to help the physician determine which drug and dosage are clinically appropriate. Quantity Duration – based on FDA recommended prescribing and safety information, the quantity duration rules helps members receive the most clinically effective dosages of medication.

If you use a Non-Participating Pharmacy, you will have to: • Pay for your prescription when it is filled; • Call the Benefit Fund’s Member Services Department for a Prescription Reimbursement Claim Form; and • Complete this form and send it along with an itemized paid receipt for your prescription to the address indicated on the form. You will only be reimbursed up to the Benefit Fund’s Schedule of Allowances. FILLING YOUR PRESCRIPTIONS For Short-Term Illnesses: If you need medication for a short period of time, such as an antibiotic, go to your local Participating Pharmacy to have your prescription filled. For Chronic Conditions: The Fund’s Mandatory Maintenance Drug Access Program – The 90-Day Rx Solution If you have a chronic condition and are required to take the same medication on a longterm basis, you must fill your prescription through the Benefit Fund’s mandatory maintenance drug access program, The 90-Day Rx Solution. This program requires that you order medications that you take on an ongoing basis in 90day supplies. For your convenience, your medication will be delivered directly to you at your choice of address. If you live in New York or New Jersey, you may choose to order and pick up your 90-day supply at a designated participating pharmacy. If you are currently taking a maintenance medication, ask your doctor for a 90-day prescription (with 3 refills) and fill it either by: • Mailing the prescription to the Benefit Fund’s mail order pharmacy, where it will normally be delivered within eight days; or • Taking it to one of the designated pharmacies in New York or New Jersey. For new maintenance medications, ask your doctor for two prescriptions: one for a 30-day supply (with one refill) and another for a 90-day supply (with 3 refills) that can be filled through the maintenance drug access program once you know that the medication works for you.

Specialty Care Members must use the Specialty Care Pharmacy Program for injectables and other drugs that require special handling. Call the Benefit Fund or visit our website at www.1199SEIUBenefits.org for a listing of drugs included in this program. Specialty Care drugs are available only through this mail delivery service.

Call the Benefit Fund at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org for the locations of pharmacies that participate in the maintenance drug access program, for a mail order form or to determine if the drug that you are taking is a maintenance medication.

Biotechnology Drugs The Benefit Fund’s payments for pharmacy benefits for medically necessary treatment are limited to $100,000 for biotechnology drugs. No additional benefits for biotechnology drugs above this limit will be considered to the extent that there are payments for such drugs available from other sources.

COORDINATING PRESCRIPTION DRUG BENEFITS If your spouse is covered for prescription medication under another healthcare plan, that plan is primary. The Benefit Fund is the secondary plan for your spouse and may provide coverage for any co-payments or deductibles that your spouse may incur up to the Benefit Fund’s Schedule of Allowances.

Step Therapy Step therapy is designed to provide safe, effective treatment while controlling prescription costs. With step therapy, you are required to try established, lower-cost, clinically appropriate alternatives before progressing to other, more costly medications, such as preferred brand names.

PROTECT YOUR CARD

USE A PARTICIPATING PHARMACY For a listing of Participating Pharmacies, call the Benefit Fund’s Member Services Department at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org.

WHAT’S NOT COVERED The Benefit Fund does not cover:

Your Rights Under the Women’s Health and Cancer Act Your 1199SEIU benefits support you every step of the way if you are battling breast cancer. The Benefit Fund makes certain you have access to quality oncology care by contracting with many of the top cancer treatment centers in the New York metropolitan area – so you don’t have to go outside your network. Your Benefit Fund also provides coverage for mastectomy-related services including reconstructive surgery and prostheses. In fact, we consider this care so critical the Benefit Fund covered it even before it was required under the federal Women’s Health and Cancer Rights Act of 1998. Depending on your doctor’s recommendation, you are covered for: • Reconstruction of the breast on which a mastectomy was performed; • Surgery and reconstruction of the other breast to achieve a symmetrical appearance; • Prostheses; and • Treatment for physical complications associated with all stages of the mastectomy, including lymphedemas. These benefits are provided under the 1199SEIU National Benefit Fund and the 1199SEIU Greater New York Benefit Fund. Coverage is subject to benefit rules, exclusions and limitations that may apply under the Plan, as permitted by law.

With Flu Season Fast Approaching, Staying Healthy Is Everyone’s Top Priority Getting a flu shot is an important preventive measure at this time of year – particularly for healthcare workers and people with chronic conditions like asthma. It may seem early to be thinking about getting one, but flu season is just around the corner. Protect yourself and your patients this year by taking advantage of the free flu shots provided by your employer at your worksite. Of course, if your employer doesn’t offer you one, it’s covered by the Benefit Fund, so just make an appointment with your primary care physician.

FOR YOUR BENEFIT

Member Profile

1199SEIU Secretary-Treasurer Maria Castaneda Lost 42 Pounds and Found a New, Healthier Way to Live Like many women, Maria Castaneda has a demanding job, as 1199SEIU Secretary-Treasurer, and a busy home life that leaves her little time to exercise or prepare healthy meals. As a result, though only 5’4”, her weight rose to 172 pounds. She knew she had to change her habits, but she didn’t know where to begin. Finally, when she turned 54 on May 23, 2009, she gave herself a wonderful birthday present: a gym membership and a personalized training program.“I realized, I don’t want to be sick,” she said. “I want to have an active, healthy lifestyle when I retire, so I better take care of my health now and still have many, many years.” Now, at 130 pounds, Maria is committed to staying healthy. Not that it was easy at the beginning. “For the first month I did not lose any weight, so I was a little disappointed,” she said. “But some of my clothes started to fit better, so my trainer asked me to keep a log of the food I ate.”That’s when Maria noticed that the potato chips and ice cream and takeout food she loved were undoing all her hard work at the gym. So she made a second commitment to her health.“I said, Okay, no more takeout. Every weekend I plan our meals, do food shopping, eliminate the takeout,” she said.“I’m Filipino, so I cook Filipino food – one-dish meals with vegetables and protein. I choose foods that are simple to prepare but healthy. I feel good about the changes because I like the food I cook.” Her husband and daughter feel good, too, as they support Maria in her commitment to create a healthier lifestyle for all of them. These days, living that lifestyle comes naturally to her. She has much more energy than she used to have, she no longer craves ice cream or potato chips, and if she’s forced to skip a workout, she actually misses it. She explains, “If you exercise and you eat the good food that you want to eat, your whole attitude changes.” Sharing her story with her co-workers, the union’s officers and staff, Maria has been an inspiration to them as well. “They started organizing walking teams at night,” she said. “They started to also modify their meal intake, and they are telling me that they have lost weight, too.” Happy with her success – she’s also dropped five dress sizes and reduced her body-fat percentage from 41.6 to 31.6 – Maria points out that the Benefit Fund offers all members the resources they need to reach their own goals.“Our Benefit Fund has a wellness program that educates our members about healthy lifestyles and wellness,” she said. “To be true to our program, I wanted to do the same thing.”

CHILDREN WITH DISABILITIES If your child is disabled, as described below, coverage for your child may continue after age 19 if all of the following additional conditions are met: • There is no other coverage available from either a government agency or through a special organization; and • Your child is not married; and • Your child became handicapped before age 19; and • You file a properly completed Disability Certification Form with the Benefit Fund each year after your child reaches age 19. Your child is disabled if the Trustees determine in their discretion that your child lacks the ability to engage in any substantial gainful activity due to any physical or mental impairment that is verified by a physician and is expected to last for a continuous period of not less than 12 months or result in death. QUALIFIED MEDICAL CHILD SUPPORT ORDER The Benefit Fund will comply with the terms of any Qualified Medical Child Support Order (QMCSO) as the term is defined in the Employee Retirement Income Security Act (ERISA) of 1974, as amended. A QMCSO may require the Benefit Fund to make coverage available to your child even though the child is not, for income tax purposes or Fund purposes, your legal dependent, because of separation or divorce.

How Secretary-Treasurer Maria Castaneda Maintains Her Healthy Weight Instead of potato chips, Maria snacks on high-protein almonds and fresh, in-season fruits that are rich in fiber and vitamins and low in calories. When eating out, she makes healthier choices, such as choosing grilled, not “crispy,” chicken. She always makes sure to eat a well-balanced breakfast and lunch so she’s not starving by dinnertime and ends up overeating. Whenever she travels for work, she tries to stay in a hotel with a gym and brings her workout clothes along with her. Even if she does overeat, she gets right back on the program: “I just tell myself, ‘Okay, you were bad today, but burn the fat when you work out,’ so I add 5 or 10 minutes to my gym routine.”

In order to be a qualified order, the medical child support order must: •Be issued by a court or authorized state agency; •Clearly specify the alternate recipient; •Reasonably describe the type of coverage to be provided to such alternate recipient; •Clearly state the period to which such order applies; and •Indicate the name and last known address of the member who is required to provide the coverage and the name and mailing address of each child covered by the order. The Plan Administrator will determine the qualified status of a medical child support order in accordance with the Benefit Fund’s written procedures. * Effective January 1, 2011, the HealthCare Reform provisions on overaged dependents up until age 26 - discussed elsewhere in this magazine – will take effect. MEDICARE AND END STAGE RENAL DISEASE (ESRD) Effective September 21, 2009, the subsection entitled “Medicare and End Stage Renal Disease (ESRD), in Section I.F, is hereby replaced with the following: In the case of an individual entitled to Medicare benefits on the basis of end stage renal disease (ESRD), the Benefit Fund will be the primary payor of benefits only for the period required by law. Thereafter, the Benefit Fund will be secondary to Medicare. To protect your benefits, you must enroll in Medicare Part A and Part B immediately upon becoming entitled to Medicare benefits. The Fund will provide reimbursement for 50% of your Medicare Part B premium. You may file a claim form once each quarter to get this benefit. Effective December 11, 2008, the second paragraph of Section I.K, “Your COBRA Rights,” regarding domestic partners, is hereby omitted. Effective September 21, 2009, the first paragraph of Section I.I, “When Your Benefits Stop,” is replaced with the following: If you are no longer employed by a Contributing Employer, stop working or your employer is not obligated to make payments to the Benefit Fund on your behalf, all benefits end 30 days after the last day for which your employer is required to make contributions to the Benefit Fund* on your behalf unless your benefits are continued as described in Sections I.D and I.H or Section VI- Retiree Health Benefits. *This may include contributions for severance or other wages paid to you, such as vacation, etc.

Effective December 3, 2009, Section II. L is hereby replaced with the following:

Section II.L PRESCRIPTION DRUGS BENEFIT BRIEF Prescription Drugs •Coverage of FDA-approved prescription medications for FDA-approved indications, except plan exclusions •No co-payments, no deductible when you use generic drugs and preferred drugs where available •Use Participating Pharmacies •Mandatory maintenance drug access program •You must comply with the Benefit Fund’s Prescription Programs. For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Wage Class I: Family Wage Class II: Not Covered Wage Class III: Not Covered If you are in Wage Class I, you, your spouse and your children are covered for prescription drugs. If you are in Wage Class II or Wage Class III, you are not covered for this benefit. WHAT IS COVERED The Benefit Fund covers drugs approved by the Food and Drug Administration (FDA) that: • Have been approved for treating your specific condition; • Have been prescribed by a licensed prescriber; and • Are filled by a licensed pharmacist. Benefits for prescriptions for FDA-approved drugs that are not approved for treatment of your condition must be submitted to the Benefit Fund office for consideration. Your doctor should provide detailed medical information and supporting documentation for prescribing this medication. USING YOUR BENEFITS To get your prescription: • Ask your doctor to prescribe only covered medications, as per the Benefit Fund’s Prescription Programs; • Use Participating Pharmacies for short-term medications; and • Show your Health Benefits ID Card to the pharmacist when you give him or her your prescription. There is no out-of-pocket cost for your prescriptions if you comply with the Benefit Fund’s prescription programs: • Mandatory generic drug program; • Preferred Drug List; • Mandatory maintenance drug access program; • Prior authorization for specified medications; • Quantity and day supply limitations; • Step therapy; and • Use the Specialty Care Pharmacy for injectables and other drugs that require special handling. PRESCRIPTION DRUG PROGRAMS For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Generic Drugs Generic Drugs are the same as brand-name drugs. The only major difference is the cost. By law, generic drugs must contain the same active ingredients in the same quantities and be the same strength as the corresponding brand-name drug. Most importantly, they must meet the same FDA standards for safety and effectiveness. When your doctor gives you a prescription: •If there is a generic equivalent for a brand-name drug, you must get the generic drug. Otherwise, you will have to pay the difference in cost between the brand-name drug and the generic equivalent. •If there is no generic equivalent, your prescription will be filled with the brand-name drug. •In rare situations, your doctor may specify the brand-name drug. In this case, your doctor must submit detailed medical information and supporting docu-

PA R A S U B E N E F I C I O

Protecting Our Health

1199SEIU NATIONAL BENEFIT FUND FOR HEALTH AND HUMAN SERVICE EMPLOYEES SUMMARY OF MATERIAL MODIFICATIONS This Summary of Material Modifications describes changes that affect your welfare benefit plan and updates the Summary Plan Description (SPD) that was previously distributed to you. You should keep this summary with your current SPD until the booklet is updated to reflect the changes discussed herein.

__________________________________________________ Section I. A of the SPD is hereby replaced with the following: Section 1.A WHO’S ELIGIBLE YOU You are eligible to participate in the 1199SEIU National Benefit Fund if: • You work for a Contributing Employer who is making contributions to the Benefit Fund on your behalf based on your employment for the benefits in this Summary Plan Description; and • You have completed the waiting period specified in your employer’s Collective Bargaining Agreement (in most cases 90 days). If you are an employee of the City of New York or an agent or authority of New York City, you are eligible for a specified package of benefits (see page 30). You may also be eligible for benefits if: • You are eligible to receive COBRA continuation coverage and you comply with the Notice Requirements and make the monthly payments required to keep this coverage (see Section I.K); or • You are a retiree eligible for specified retiree health benefits (see Retiree Health Benefits, Section VI.A). YOUR SPOUSE OR SAME-SEX PARTNER (effective December 11, 2008) Your spouse may be eligible if: • You and your spouse are legally married; and • You are eligible for Family cover-age, based on Your Wage Class (see Section I.D). If you and your spouse are legally divorced or legally separated, your spouse is not covered by the Benefit Fund, unless required by court order. Your same-sex partner may be eligible if all the following conditions are met: 1) You are eligible for family coverage based on your Wage Class (see Section I. D), and 2) If you and your same-sex partner reside in a city, county or state which either a) provides for the legal recognition of: i. same-sex marriage, and you have entered into such a relationship and submitted the required documents, which have been accepted by the Fund; or ii. same-sex civil unions (but not same-sex marriage), and you have entered into such a relationship and submitted the required documents, which have been accepted by the Fund; or iii. same-sex domestic partnerships (but neither same-sex marriage nor same-sex civil unions), and you have entered into such a relationship and submitted the required documents, which have been accepted by the Fund; or b) does not provide for legal recognition of same-sex relationships, but i. you have received legal recognition of your same-sex relationship in another city, county, state or country and submitted the required documents, which have been accepted by the Fund; or ii. the following conditions are met: • You and your same-sex partner are in a committed, same-sex relationship, which is similar to marriage; • This relationship has been in existence for at least twelve (12) months; • You and your same-sex partner are both age 18 or older; • You and your same-sex partner are financially and emotionally dependent upon each other; • You and your same-sex partner live together at the same address and intend to do so indefinitely; • You and your same-sex partner intend for your relationship to be permanent; • Neither you nor your same-sex partner are married or are related by

blood in a manner that would bar marriage in the State of New York; • You have submitted an Affidavit of Domestic Partnership and other required documents, which have been accepted by the Benefit Fund. The Plan Administrator reserves the right, in its sole and absolute discretion, to determine all questions relating to the eligibility of same-sex partners. PLEASE NOTE: Changes within your family that relate to eligibility must be reported to the Benefit Fund immediately and in no case more than 30 days from the date of the event. Such changes include: • separation or divorce of a spouse, • legal termination of a civil union or legally recognized domestic partnership, • failure to continue to meet the eligibility conditions set forth by the Fund above for recognition of your same-sex relationship, or • change in status of your dependent children. Except as provided by court order, Benefit Fund coverage of a spouse or same-sex partner ends upon separation or divorce, legal termination of a civil union or legally recognized domestic partnership, or change in status of same-sex relationship such that it no longer meets the eligibility conditions set forth by the Fund. YOUR CHILDREN * Your children are eligible up to their 19th birthday if all the following conditions are met: • They’re your biological children; or • They’re your legally adopted children (coverage for legally adopted children starts from placement); or • You are their legal parent identified on their birth certificate; and • They’re dependent on you for their full support and are living permanently with you, or an appropriate court issues a qualified medical child support order Which provides otherwise (see box in Section I.A); • They’re not married; and • You are eligible for family cover-age, based on your Wage Class (see Section I.D). Your stepchildren, foster children and grandchildren are not covered by the Benefit Fund. Children of your same-sex partner cannot be covered by the Benefit Fund, unless you are their legally recognized parent or they are legally adopted by or placed for adoption with you. AFTER YOUR CHILD REACHES AGE 19 (effective January 1, 2010) Your child’s coverage may be continued from your child’s 19th birthday up to his or her 23rd birthday if: • He or she is a full-time matriculated student attending high school or college, not married, not working full-time, living at home or school, and totally dependent on you for support (“totally dependent”); and • You file a properly completed Dependent Recertification Form with the Benefit Fund when your child turns age 19 and each year after that until your child’s 23rd birthday. Your child is not a dependent if he/she: • Lives outside of the United States; or • Is in the military or similar forces of any country or subdivision thereof. EXTENSION OF COVERAGE FOR STUDENTS UNDER MICHELLE’S LAW Effective January 1, 2010, if your totally dependent child who is enrolled full-time in high school or college takes a medically necessary leave of absence due to a serious illness or injury and the Benefit Fund has received written certification of the medical necessity by his or her treating physician, your child’s coverage may be continued for up to one year after the first day of the leave of absence or the date coverage would otherwise terminate under the terms of the Benefit Fund (if earlier) (for instance, upon your child’s 23rd birthday).

Savor Fall’s Seasonal Fruits and Vegetables The new Dietary Guidelines for Americans recommend fighting obesity and improving our health by adding more plants to our diets. Fall is an easy time to add more fruits and vegetables to our diets, because so many delicious options are in season.They’re important sources of many nutrients, including potassium, vitamins A, C and E, and folic acid, plus their dietary fiber helps reduce blood cholesterol levels and may lower your risk for heart disease. Among the many luscious fruits that are at the height of their flavor in the fall are apples, pears and grapes, while vegetables such as sweet potatoes, green beans, eggplant, broccoli and most leafy greens like collard greens, kale and chard are at their tastiest, too. It’s easier than ever for you to enjoy seasonal fruits and vegetables. For members living in New York City and its boroughs, the city has made a big push to open more local farmers markets and get more Green Carts on the streets. You can choose

from 50 farmers markets throughout the five boroughs. All are open in the fall, and some are even open year-round.You can find a farmers market near you on the GrowNYC website at www.cenyc.org/files/gmkt/map.pdf. You can also look for a NYC Green Cart in your neighborhood.These carts, licensed by the New York City Department of Health, are designed to bring fresh fruits and vegetables to areas of the city that have high rates of obesity and diabetes. For example, if you live in the Bronx, there’s a Green Cart at the corner of Fordham Road and Decatur Avenue, near Montefiore Medical Center. For our Long Island, Hudson Valley and Upstate members, dozens of farm stands and farmers markets sell locally grown, in-season produce. Find one near you at www.agmkt.state.ny.us/AP/FFGSearch.asp. So fill your table with some spinach, squash and cranberries while they’re still in season.

FOR YOUR BENEFIT

Protecting Our Health

2010 Dietary Guidelines for Americans Will Recommend Eating Less, Exercising More Every five years, the USDA and the Department of Health and Human Services review and update the Dietary Guidelines for Americans.These guidelines are designed to help us improve our diets to avoid chronic disease and stay healthy.The 2010 Dietary Guidelines will be released at the end of this year, but the preliminary report already shows that they will focus on one of the biggest health issues in the news today: rising obesity rates.The final guidelines will almost certainly recommend ways that we can fight obesity by reducing overall calorie intake and increasing physical activity. Here are some of the committee’s key initial recommendations for eating a healthy diet and maintaining a healthy weight – along with some tips on how to achieve them!

Eat a more plant-based diet that emphasizes vegetables, beans, whole grains, nuts and seeds •

Check out your local farmers market or Green Cart for seasonal fruits and vegetables (see p. 7)

•

Make one night a week “meatless”: Substitute beans, tofu or another meat alternative in your usual recipe (for recipes, check out Eater’s Digest’s Meatless Monday page at www.meatlessmonday.com)

•

Go vegetarian until dinner: Choose fruits, vegetables, low-fat yogurt and whole-grain cereals and breads for breakfast and lunch

Increase your intake of seafood and fatfree and low-fat milk and milk products •

Make a breakfast shake with fresh or frozen fruit and low-fat yogurt

•

Experiment with fish high in “good” omega-3 fatty acids like salmon and trout

Eat fewer foods that contain added sugars and solid fats •

Shop the perimeter: Choose the whole foods at the edge of your grocery store like fruits, vegetables, dairy and lean meats instead of the processed convenience foods in the center aisles

Reduce sodium • •

Try new seasonings like lemon or fresh herbs instead of salt Cook rice, pasta and other grains without adding salt to the cooking water, and cut back on instant or flavored versions that can be high in sodium

Eat fewer refined grains •

Make half your grains whole: Choose whole wheat over white bread, and brown or wild over white rice

Apoyo continuo y personalizado, sólo para usted Como miembro de 1199SEIU, tiene un recurso de salud personal a su disposición, en cualquier momento que lo necesite. Puede recibir asistencia personal por teléfono sólo con llamar a nuestro Servicio de Entrenamiento de Salud y hablar con una enfermera capacitada y calificada. Su entrenador trabajará con usted a lo largo del tiempo, cada vez que necesite hablar, para ayudarlo a controlar una enfermedad crónica o mejorar su dieta, iniciar un estilo de vida más activo o incluso dejar de fumar. También es nuestra línea de ayuda de enfermería las 24 horas, a la que puede llamar en cualquier momento del día o la noche, los siete días de la semana, para hacer cualquier pregunta médica.

Servicio de Entrenamiento de Salud y la Línea de Ayuda de Enfermería de 1199SEIU

(866) 935-1199 Mantenerse Saludable es Divertido Cuando se Hace en Familia Únase a nosotros en un taller especial sobre nutrición, que lo ayudará a planificar y preparar comidas nutritivas con bajo contenido de grasa para su familia. Trabajará con nutricionistas certificados que pueden responder a sus preguntas y luego del taller, únase a otras familias de 1199SEIU para hacer ejercicio en una clase destinada a todas las edades. Traiga a toda la familia y llévese a casa una copia de nuestro libro de cocina del Fondo de Beneficios, What’s Cooking (¿Qué está cocinando?).

Sábado 9 de octubre Comidas saludables en 30 minutos Taller de nutrición para la familia De 10:30 a.m. a 11:30 a.m. Clase de ejercicios para todas las edades 11:45 a.m. a 12:30 p.m. Taller de manejo del estrés Infórmese sobre las herramientas que lo ayudarán a comprender y a manejar la presión de sus actividades diarias 12:45 p. m. a 1:30 p. m. La inscripción comienza a las 10:00 a.m. 330 W 42nd Street, Penthouse Estacionamiento validado de $10 al frente, en Impark Guardería para niños mayores de 3 años Llame para hacer reservaciones (646) 473-8960 opción 2

Linguine de espinaca Rinde 4 picada con atún porciones Ingredientes: 1/4 taza de aceite de oliva 1/4 taza de cebolla picada 1 diente de ajo molido 1 lata de atún seco 12 onzas de linguine 3 cucharadas de jugo fresco de limón 1/4 taza de espinaca picada, congelada, seca

Indicaciones: Caliente el aceite en una sartén mediana. Agregue la cebolla. Después de 5 minutos, agregue el ajo. Incorpore el atún y el jugo de limón. Mientras, cocine los linguine en abundante agua hirviendo con sal hasta que estén a punto, aproximadamente 12 minutos. Mezcle en un tazón la mezcla de salsa de atún con la pasta y sirva.

¡Recomendación del nutricionista! Esta receta es baja en grasas saturadas y es una buena fuente de fibra cuando se agrega más espinaca. El plato es rico en carbohidratos complejos y proteínas. ¡Además, es una buena fuente de vitamina C y ácido fólico gracias a la espinaca! Use sólo 3 cucharadas de aceite de oliva. Use 4 tazas de espinaca cruda picada en vez de sólo 1/4 de taza.

Contenido Nutricional por porción (por aprox. 1 taza de pasta cocida)

Calorías 385 Carbohidratos 51.1g Sodio 312mg Colesterol 18.1mg Fibra 4.4g Grasas 9.9g Grasas saturadas 1.23g AGMI 5.3g AGPI 1.1g Proteínas 23g

PA R A S U B E N E F I C I O

La Esquina del Acondicionamiento Físico

Camine hacia una Mejor Salud

Semana Programa de caminata* (tiempo de caminata vigorosa, 3 días a la semana)

1 2 3 4 5 6 7 8 9 10 11 12

Lo ha oído muchas veces, pero el hecho sigue siendo que caminar es la manera más fácil y económica de comenzar a ejercitar.Y se dice que hay grupos de miembros que ya se están beneficiando de ello, pues han formado equipos de caminata en el trabajo para alentarse y apoyarse los unos a los otros, a alcanzar sus objetivos de acondicionamiento físico. Si usted es como muchos miembros que desean ejercitarse, pero no saben cómo comenzar, caminar, en grupos para tener apoyo, podría ser justo lo que su médico le recetó. Para que se transforme en un hábito, el ejercicio debe ser agradable. El objetivo es tener una buena salud. No es necesario que su camino al acondicionamiento físico involucre la falta de aire ni tener músculos doloridos. Recuerde que es un principiante y puede comenzar lentamente a hacer ejercicios a su propio ritmo. De acuerdo con el programa del Instituto Nacional del Corazón, el Pulmón y la Sangre (consulte la tabla), usted puede comenzar con una rutina de caminata de manera muy paulatina. La primera semana, sólo necesita caminar vigorosamente durante cinco minutos, tres veces en esa semana, algo que todos podemos hacer, ya sea durante un receso del trabajo o en nuestro vecindario. El resto del plan aumenta su actividad de manera lenta pero constante. Piense en caminar con alguien para que pueda caminar con un colega durante la hora de almuerzo o ponerse al día con las noticias con su esposa o uno de sus hijos después de que termine el día de trabajo. Pero si lo hace, puede estar seguro de que está haciendo algo bueno para usted y de que después de unas cuantas veces, comenzará a sentir los beneficios de caminar simplemente hacia una mejor salud.

5 minutos 7 minutos 9 minutos 11 minutos 13 minutos 15 minutos 18 minutos 20 minutos 23 minutos 26 minutos 28 minutos 30 minutos

Total semanal

15 minutos 21 minutos 27 minutos 33 minutos 39 minutos 45 minutos 54 minutos 60 minutos 69 minutos 78 minutos 84 minutos 90 minutos

Fuente: mayoclinic.com/health/walking/SM00060

Cómo Crear un Equipo de Caminata •

Comente la idea. Converse con amigos, colegas y familiares que pudieran estar listos para unirse, o ponga un aviso en la sala de receso.

•

Organícense. Haga una reunión de inicio del equipo y recopile la información de contacto. Converse sobre la frecuencia con que saldrán a caminar, cuáles serán sus rutas y otros detalles.

•

Una vez que empiece a caminar, mantenga un registro de su progreso y motive al resto con un registro de las millas y los tiempos de su equipo en Internet.

•

Mantenga vivo el interés. Busque maneras de motivarse entre sí para continuar, como hacer caminatas de caridad, darle un nombre al equipo o diseñar camisetas.

Acepte el desafío: Cree un equipo de caminata en su lugar de trabajo con sus colegas y promueva una cultura de la salud. Si necesita ayuda para comenzar, comuníquese con su Coordinador de Ayuda.

Increase physical activity to at least two and a half hours each week for adults, and one hour a day for children I Attend one of our Benefit Fund’s Wellness fitness workshops, and bring the whole family I Take advantage of discounted memberships for 1199SEIU members at the Greater New York YMCAs,

New York Sports Clubs and Crunch Fitness I Spend your day off playing Frisbee, kicking a soccer ball or taking a walk with your family at your

local park.You can also join one of the inexpensive or free exercise classes offered at many of the New York City parks’ recreational facilities. Find one near you at www.nycgovparks.org.

FOR YOUR BENEFIT

Fitness Corner

Walking Yourself to Better Health You’ve heard it many times, but the fact remains that walking is the easiest, most affordable way to begin to exercise. And word has it that groups of members are already benefiting from it by forming walking teams at work to encourage and support each other to reach their fitness goals. So if you are like many members who want to exercise but don’t know how to start, walking – and walking in groups for support – may be just what the doctor ordered. To become a habit, exercise needs to be enjoyable. You are aiming for good health.Your road to fitness doesn’t have to include gasping for air or sore muscles. Remember that you are a beginner and you can ease yourself into exercise on your own schedule. According to the National Heart, Lung, and Blood Institute schedule (see chart), you can truly ease into a walking routine.The first week, you need only walk briskly for five minutes, three times that week – something we can all accomplish, whether on a work break or in our neighborhood.The rest of the plan increases your activity slowly but steadily.Think about walking with someone so you can talk with a colleague during a lunchtime walk or catch up on news with your spouse or one of your children after the workday ends. However you do it, you can be sure you are doing something good for yourself, and that after a few times, you will begin to feel the benefits of simply walking yourself to better health.

Week

Walking Schedule* (brisk walking time, 3 days per week)

Weekly Total

1 2 3 4 5 6 7 8 9 10 11 12

5 minutes 7 minutes 9 minutes 11 minutes 13 minutes 15 minutes 18 minutes 20 minutes 23 minutes 26 minutes 28 minutes 30 minutes

15 minutes 21 minutes 27 minutes 33 minutes 39 minutes 45 minutes 54 minutes 60 minutes 69 minutes 78 minutes 84 minutes 90 minutes

Source: mayoclinic.com/health/walking/SM00060

How to Start a Walking Team •

Spread the word. Talk to friends, colleagues and family who might be ready to join you, or put up a notice in the Break Room.

•

Get organized. Hold a team kickoff meeting and collect contact information. Discuss how often to walk, what your routes will be and other details.

•

Once you begin walking, keep track of your progress and build momentum by logging your team's miles and times online.

•

Keep the interest alive. Look for ways to encourage each other to continue, such as walking for charities, giving your team a name or designing T-shirts.

So take the challenge: Create a walking team at your worksite with your colleagues and promote a culture of health. If you need help getting started, contact your Outreach Coordinator.

Aumente la actividad física a por lo menos dos horas y media a la semana para los adultos y una hora diaria para los niños. I Asista a uno de nuestros talleres de acondicionamiento físico del Programa Bienestar del Fondo de

Beneficios, y traiga a toda la familia. I Aproveche las membresías con descuentos para los miembros de 1199SEIU en YMCA, New York

Sports Clubs y Crunch Fitness del Gran Nueva York. I Pase su día libre jugando frisbee, pateando una pelota de fútbol o caminando con su familia en su

parque local.También puede unirse a una de las clases de ejercicios baratas o gratuitas que se ofrecen en muchos de los establecimientos recreativos de los parques de la ciudad de Nueva York. Encuentre uno cercano en www.nycgovparks.org.

PA R A S U B E N E F I C I O

Protecting Our Health

Las Guías Alimentarias para los Estadounidenses (Dietary Guidelines for Americans) del 2010 Recomendarán Comer Menos y Ejercitar Más Cada cinco años, el Departamento de Agricultura de los Estados Unidos y el Departamento de Salud y Servicios Humanos revisan y actualizan las Guías Alimentarias para los Estadounidenses. Estas guías han sido diseñadas para ayudarnos a mejorar nuestras dietas a fin de evitar enfermedades crónicas y mantenernos saludables. Las Guías Alimentarias del 2010 se publicarán al término de este año, pero el informe preliminar ya muestra que se centrará en uno de los mayores problemas de salud que aparece actualmente en las noticias: el aumento en la tasa de obesidad. Casi con seguridad, las guías definitivas recomendarán formas en las que podemos combatir la obesidad, al reducir el consumo general de calorías y aumentar la actividad física. A continuación se encuentran algunas de las primeras recomendaciones clave del comité para consumir una dieta saludable y mantener un peso saludable, junto con algunos consejos para conseguirlas.

Consuma una dieta que se base más en el origen vegetal, que se centre en las verduras, los frijoles, los productos integrales, los frutos secos y las semillas. • Conozca su mercado agrícola local o Green Cart, donde encontrará frutas y verduras de la temporada (consulte la página 12). • Transforme una noche a la semana en la noche “sin carne”: substituya la carne con frijoles, tofu o alguna otra alternativa en su receta normal (para obtener recetas, revise la página de Lunes sin carne de Eater’s Digest, en www.meatlessmonday.com) • Conviértase en vegetariano hasta la cena: elija frutas, verduras, yogurt con bajo contenido de grasa, cereales y pan integrales para el desayuno y el almuerzo. Aumente el consumo de mariscos y productos lácteos de bajo contenido graso o descremados. • Para el desayuno, prepare un batido con frutas frescas o congeladas y yogur con bajo contenido de grasa. • Experimente con pescado con alto contenido de ácidos grasos Omega 3 “buenos”, como el salmón y la trucha. Consuma menos alimentos que contengan azúcares agregados y grasas sólidas. • Compre por el perímetro: escoja alimentos completos en las orillas de su tienda de alimentos como frutas, verduras, lácteos y carnes magras, en lugar de los alimentos de preparación rápida de los pasillos centrales. Reduzca el consumo de sodio. • Pruebe condimentos nuevos como el limón o las hierbas frescas en lugar de la sal. • Cocine el arroz, las pastas y otros productos integrales sin agregarle sal al agua en que las cocine, y reduzca las versiones instantáneas o con sabor que pueden tener un alto contenido de sodio. Consuma menos granos refinados. • La mitad de los cereales que consuma deben ser integrales: prefiera el pan de trigo integral en vez del pan blanco y el arroz integral o silvestre, en vez del arroz blanco.

Round-the-Clock One-on-One Support, Just for You As an 1199SEIU member, you’ve got a personal health resource at your disposal, any time you need it! You can receive one-on-one support by phone just by calling our Health Coaching Service and speaking to a trained, qualified nurse. Your coach will work with you over time, whenever you need to talk, to help you manage an ongoing health condition or improve your diet, start a more active lifestyle or even quit smoking. It’s also our 24-Hour Nurse Helpline, which you can call any time of the day or night, seven days a week, for any medical questions.

1199SEIU Nurse Helpline and Health Coaching Service

(866) 935-1199

Staying Healthy Is Fun When It’s a Family Affair Join us for a special nutrition workshop that will help you plan and cook nutritious, low-fat meals for your family.You’ll work with a registered dietitian who can answer your questions, and after the workshop, join other 1199SEIU families for an all-ages exercise class. So bring the whole family and take a copy of our Benefit Fund cookbook, What’s Cooking, home with you!

Saturday, October 9 Healthy Meals in 30 Minutes Family Nutrition Workshop 10:30 am to 11:30 am All-Ages Exercise Class 11:45 am to 12:30 pm

Please call to reserve (646) 473-8960 option 2

Stress Management Workshop Learn Tools to Help You Understand and Manage the Pressure from Your Daily Activities 12:45 pm to 1:30 pm Registration starts at 10:00 am 330 W. 42nd Street, Penthouse Validated $10 parking across the street at Impark Child care for children 3 years old and up

Chopped Linguine serves four Spinach with Tuna Ingredients: 1/4 cup olive oil 1/4 cup chopped onion 1 garlic clove, crushed 1 can tuna, dry 12 oz. of linguine 3 tbsp. fresh lemon juice 1/4 cup frozen chopped spinach, dry

Directions: Heat oil in a medium skillet. Add onion. After 5 minutes, add garlic. Stir in tuna and lemon juice. Meanwhile, cook linguine in plenty of boiling water until firm to the bite, about 12 minutes. Toss the tuna sauce mixture in a bowl with the pasta and serve.

Nutritionist Recommendation! This recipe is low in saturated fat and a good source of fiber when more spinach is added. The dish is high in complex carbohydrates and protein. Plus, it is a good source of vitamin C and folic acid all thanks to the spinach! Use only 3 tablespoons of olive oil. Use 4 cups raw chopped spinach instead of only 1/4 cup.

Nutritional Content by Serving (estimated 1 cup cooked pasta) Calories 385 Carbs 51.1g Sodium 312mg Cholesterol 18.1mg Fiber 4.4g Fat 9.9g Saturated Fat 1.23g MUFA 5.3g PUFA 1.1g Protein 23g

FOR YOUR BENEFIT

Otoño de 2010

Protección de Nuestra Salud

DEDICADO A LA SALUD Y EL BIENESTAR DE LOS MIEMBROS DE 1199SEIU

Para Su Beneficio Mensaje de la Directora Ejecutiva Como miembro de 1199SEIU, su cobertura de beneficio de salud se encuentra entre las mejores del país, la misma que la ley de atención de salud del Presidente Obama pretende lograr para la mayoría de los estadounidenses. Aunque usted ya disfruta de muchos de los beneficios (y más) de los que ofrece la nueva ley, se producirán algunos cambios para los miembros de 1199SEIU a partir de enero de 2011. En esta edición de su revista para miembros, Para su beneficio, podrá leer acerca de dichos cambios, que incluyen una extensión de la cobertura para hijos dependientes hasta los 26 años y la eliminación de los límites de beneficio máximos de por vida. También aprenderá a proteger su salud, y los beneficios que ha obtenido con tanto esfuerzo, al evitar ir a la Sala de Urgencias y acudiendo a uno de nuestros Centros de Atención de Urgencia o Centros de Salud sin Cita Previa cuando necesite atención médica pero no logra contactar a su médico. También podrá leer sobre la nueva convocatoria de las pautas alimentarias federales para los estadounidenses, a fin de reducir las calorías y aumentar el ejercicio, y saber cómo hacerlo con ayuda de nuestros talleres de salud y membresías para gimnasios con descuentos. Además, la misma Secretaria-Tesorera de 1199SEIU, Maria Castaneda, lo inspirará con su historia sobre cómo un compromiso hecho para terminar con los malos hábitos y reemplazarlos con hábitos saludables, la ayudó a bajar más de 40 libras. ¡Incluso puede comenzar a lograr sus propios objetivos de salud, si se inscribe en el Taller de nutrición el 9 de octubre, en la sede central de Nueva York del Fondo! Asegúrese de aprovechar al máximo todos los beneficios que le ofrece su Fondo.Y, como siempre, esperamos que las noticias de su revista para los miembros sean útiles e informativas.

Atentamente,

Mitra Behroozi Directora ejecutiva Fondos de Beneficios y Pensiones de 1199SEIU

Saboree las Frutas y Verduras de la Temporada este Otoño Las nuevas guías alimentarias para estadounidenses recomiendan combatir la obesidad y mejorar nuestra salud, al agregar más verduras a nuestra dieta. El otoño es un buen momento para agregar más frutas y verduras a nuestras dietas, porque durante esta temporada se dispone de muchas opciones deliciosas. Son fuentes importantes de muchos nutrientes, como el potasio, las vitaminas A, C y E, y el ácido fólico. Además, su fibra dietética ayuda a reducir los niveles de colesterol en la sangre y podría reducir el riesgo de padecer enfermedades cardíacas. Entre las muchas frutas deliciosas cuyo sabor está en su máximo en otoño, están las manzanas, las peras y las uvas, mientras que las verduras como los camotes, las habichuelas verdes, la berenjena, el brócoli y la mayoría de las verduras de hojas verdes como las hojas verdes de berza, la col rizada y la acelga se encuentran en su mejor momento, también. Es más fácil que nunca para usted disfrutar de las frutas y verduras de la temporada. Para los miembros que viven en la ciudad de Nueva York y sus distritos, la ciudad ha hecho un gran esfuerzo por abrir más mercados agrícolas o conseguir más

Green Carts para las calles. Puede escoger entre 50 mercados agrícolas en los cinco distritos.Todos se encuentran abiertos durante el otoño y algunos están abiertos todo el año. Puede encontrar un mercado agrícola cercano en el sitio Web de GrowNYC en www.cenyc.org/files/gmkt/map.pdf También puede buscar un Green Cart de la ciudad de Nueva York en su vecindario. Estos carros, autorizados por el Departamento de Salud de la ciudad de Nueva York, están diseñados para llevar frutas y verduras frescas a las áreas de la ciudad que tienen tasas elevadas de obesidad y diabetes. Por ejemplo, si vive en el Bronx, hay un Green Cart en la esquina de Fordham Road y Decatur Avenue, cerca de Montefiore Medical Center. Para nuestros miembros de Long Island, Hudson Valley y sector norte del estado, docenas de puestos y mercados agrícolas venden productos de la temporada cultivados localmente. Encuentre uno cercano en www.agmkt.state.ny.us/AP/FFGSearch.asp. Entonces, colme su mesa con espinacas, calabaza y arándanos mientras se encuentran en temporada.

PA R A S U B E N E F I C I O

Perfil del Miembro

Perdió 42 Libras y Encontró una Manera Nueva y Saludable de Vivir Al igual que muchas mujeres, Maria Castaneda tiene un trabajo exigente, como Secretaria-Tesorera de 1199SEIU, y una ocupada vida en su hogar que le deja poco tiempo para hacer ejercicios o preparar comidas saludables. Como resultado, aunque sólo mide 5’4’’, su peso llegó a las 172 libras. Sabía que tenía que cambiar sus hábitos, pero no sabía dónde comenzar. Finalmente, cuando cumplió 54 años, el 23 de mayo de 2009, se hizo un maravilloso regalo de cumpleaños: una membresía al gimnasio y un programa de entrenamiento personalizado. “Me di cuenta de que no quiero estar enferma,” comentó. “Quiero tener un estilo de vida activo y saludable cuando jubile, por lo que es mejor que me haga cargo de mi salud ahora y así disponer de muchos años más.” Actualmente, con 130 libras, Maria está comprometida a mantenerse saludable. No fue fácil al comienzo. “Durante el primer mes no perdí nada de peso, por lo que estaba un poco decepcionada,” comentó. “Pero algunas prendas comenzaron a quedarme mejor, por lo que mi entrenador me pidió que mantuviera un registro de los alimentos que consumía.” Ahí es cuando Maria notó que las patatas fritas, los helados y la comida para llevar que tanto le gustaban, estaban revirtiendo todo su esfuerzo en el gimnasio. Entonces, ella hizo un segundo compromiso con su salud. “Dije, ‘Muy bien, nada más de comida para llevar. Cada fin de semana planifico nuestras comidas, hago las compras de alimentos y elimino la comida para llevar,’”dijo. “Soy filipina, por lo que cocino comida de Filipinas, comidas de un sólo plato con verduras y proteínas. Escojo alimentos que son de preparación simple, pero saludables. Me siento bien con los cambios porque me gusta la comida que preparo.” Su esposo y su hija se sienten bien también, dado que apoyan a Maria en su compromiso de crear un estilo de vida saludable para todos ellos. Actualmente, vivir ese estilo de vida se da de manera natural para Maria. Tiene mucha más energía que la que solía tener, ya no anhela comer helados o patatas fritas, y si está obligada a faltar al gimnasio, echa de menos ejercitar. Ella explicó, “Si haces ejercicios e ingieres los alimentos buenos que deseas comer, cambia la actitud completa." Al compartir su historia con sus colegas, los funcionarios del sindicato y el personal, Maria ha sido una inspiración para ellos también. “Empezaron a organizar equipos de caminatas durante las noches,” comentó Maria. “También comenzaron a modificar la ingesta de comidas, y me comentan que también han perdido peso." Feliz con su éxito (también ha disminuido 5 tallas de vestido y ha reducido su porcentaje de grasa corporal de un 41.6 a 31.6), Maria señala que el Fondo de Beneficios les ofrece a todos los miembros los recursos necesarios para alcanzar sus propias metas. Comentó que "nuestro Fondo de Beneficios cuenta con un programa de bienestar que educa a nuestros miembros acerca de estilos de vida saludables y el bienestar." “Para ser fiel con nuestro programa, quise hacer lo mismo."

Cómo Mantiene su Peso Saludable la SecretariaTesorera Maria Castaneda En lugar de patatas fritas, Maria come refrigerios de almendras con alto contenido de proteínas y frutas frescas de la temporada que poseen mucha fibra y vitaminas, y son bajas en calorías. Cuando come afuera, elije las opciones más saludables, como pollo asado a la parrilla en vez de empanado “crocante.” Siempre se asegura de ingerir un desayuno y almuerzo bien balanceados para no tener mucha hambre a la hora de la cena y terminar comiendo demasiado. Cada vez que viaja por trabajo, trata de hospedarse en un hotel con gimnasio y lleva su ropa de ejercicios. Incluso cuando come demasiado, se corrige inmediatamente. “Sólo me digo, ‘Está bien, te portaste mal hoy, pero quema la grasa cuando ejercites,' entonces agrego 5 ó 10 minutos a la rutina de ejercicios."

La nueva ley de reforma a la salud del Presidente Obama, también conocida como Ley de Medidas de Protección del Paciente y Cuidado de Bajo Costo, significa buenas noticias para la nación y buenas noticias para usted y su familia. En nuestra última edición, le informamos que probablemente no se llevarían a cabo algunos cambios hasta el siguiente acuerdo de negociación colectiva (CBA, por sus siglas en inglés), debido a que la práctica jurídica normal con la mayoría de los cambios legislativos ha sido esperar hasta el vencimiento del CBA. Sin embargo, la administración de Obama desearía ver muchas de sus nuevas disposiciones implementadas lo más pronto posible para garantizar que millones de estadounidenses obtengan la atención que necesitan. De hecho, ya se encuentran vigentes las disposiciones más importantes que afectan a los aseguradores comerciales, como la prohibición de la discriminación contra quienes padecen enfermedades preexistentes. (Aunque el Fondo nunca ha cancelado o denegado la cobertura a algún miembro o dependiente, todos hemos escuchado las horribles historias sobre compañías aseguradoras o HMO que niegan regularmente la cobertura a quienes más la necesitan).

Cobertura para Dependientes hasta los 26 Años Aunque el Fondo de Beneficios ha cubierto a hijos dependientes hasta los 23 años si están estudiando, la nueva ley exige la cobertura para dependientes hasta los 26 años, sin importar su condición de estudiante si no tienen cobertura del empleador por su cuenta. Si tiene un hijo dependiente menor de 26 años, esté atento a los nuevos formularios de inscripción que le enviaremos este otoño. Si su cónyuge tiene cobertura de salud del empleador, se aplicará “la regla del cumpleaños” para determinar si su dependiente se encuentra cubierto por los Fondos de Beneficios de 1199SEIU o el plan de salud de su cónyuge.

¿Quién es elegible y considerado como hijo dependiente? Sus hijos biológicos o legalmente adoptados cuentan con cobertura (la cobertura para los hijos legalmente adoptados comienza con la colocación). Los hijastros, hijos bajo tutela y nietos no se encuentran cubiertos por el Fondo. El fondo no puede cubrir a los hijos de su pareja conviviente, a menos que los haya adoptado legalmente o hayan sido colocados para adopción con usted. ¿Cuál es la regla del cumpleaños? Como cualquier otro hijo, si tanto usted como su cónyuge tienen cobertura para dependientes, su hijo también deberá inscribirse en el plan de su cónyuge. El pagador principal será el plan del padre o madre cuyo cumpleaños sea antes en el año; y el plan del otro padre o madre será el pagador secundario.

No obstante, se requiere que otras disposiciones, como la cobertura para dependientes de hasta 26 años y la eliminación de los máximos de por vida, entren en vigencia el primer año del plan después del 23 de septiembre de 2010, que corresponde al 1 de enero de 2011, para nuestro Fondo de Beneficios. El Fondo comenzará con la reinscripción de todos los miembros y dependientes más adelante durante este otoño, para garantizar que todos los que tengan derecho a nuestros beneficios integrales los reciban. Esté atento a los nuevos formularios de inscripción que le enviaremos.

Acerca de sus beneficios

Maria Castaneda, Secretaria-Tesorera de 1199SEIU

La Nueva Ley de Reforma a la Salud Extiende la Cobertura para Usted y su Familia

Si tiene alguna pregunta sobre los beneficios o la cobertura, comuníquese con nuestro Departamento de Servicios para los Miembros al (646) 473-9200 o converse con su Coordinador de Ayuda. ¡Su Fondo está disponible para usted! Naturalmente, al momento de negociar el acuerdo de negociación colectiva durante el verano pasado, no se previó el costo de millones de dólares de esta nueva cobertura, por lo que tendremos que ser más precavidos que nunca procurando gastar cada dólar de manera sabia y buscar nuevas oportunidades para ahorrar en costos.

Se Eliminan los Beneficios Máximos de por Vida Mientras la mayoría de los miembros nunca alcanzan los beneficios máximos en nuestro Fondo, a partir del 1 de enero de 2011, el Fondo Nacional de Beneficios eliminará su máximo de por vida de $1,000,000 de Member Choice y el máximo de $500,000 para quienes no están inscritos en Member Choice. También se eliminará el beneficio máximo de $500,000 del Fondo de Beneficios del Gran Nueva York (para miembros de tiendas de Nueva York). Si recientemente alcanzó el beneficio máximo de por vida, comuníquese con Servicios para los Miembros al (646) 473-9200 para analizar reincorporar la atención de transición al Fondo.

PA R A S U B E N E F I C I O

Sus Derechos según la Ley de Derechos sobre la Salud y el Cáncer de la Mujer Evite las Largas Esperas en la Sala de Urgencias: Use Nuestra Red de Atención de Urgencia del Fondo de Beneficios De acuerdo con un nuevo informe del Colegio Estadounidense de Médicos de Emergencia (American College of Emergency Physicians), los neoyorquinos esperan un promedio de cinco horas cuando visitan los Departamentos de Urgencias de los hospitales. ¡Es uno de los tiempos de espera más largos del país! Recuerde que usted y su familia pueden evitar esa frustración al visitar uno de nuestros Centros de Atención de Urgencia o Centros de Salud sin Cita Previa cuando necesite atención rápidamente. Los Centros de Atención de Urgencia y Centros de Salud sin Cita Previa ofrecen un horario ampliado y tratan condiciones de urgencia pero no de emergencia como la gripe, reacciones alérgicas, además de lesiones y quemaduras leves. Además el personal de un Centro de Atención de Urgencia o un Centro de Salud sin Cita Previa tendrá más tiempo que un ocupado médico de la Sala de Urgencias para preguntarle acerca de sus antecedentes médicos y responder sus preguntas. Para obtener una lista de los Centros de Atención de Urgencia y Centros de Salud sin Cita Previa convenientes para usted, visite www.1199SEIUBenefits.org. También puede tener acceso a la atención sin dejar su hogar, si llama a la Línea de Ayuda de Enfermería o a los Entrenadores de Salud de 1199SEIU al (866) 935-1199 para obtener atención las 24 horas, los siete días de la semana y para obtener respuestas a sus preguntas.

Sus beneficios de 1199SEIU lo apoyan en cada paso del camino cuando combate el cáncer de mama. El Fondo de Beneficios le garantiza el acceso a atención de oncología de calidad ya que tiene contratos con una gran parte de los mejores centros de tratamiento contra el cáncer del área metropolitana de Nueva York, de manera que no tenga que salir de su red. El Fondo de Beneficios también proporciona cobertura para servicios relacionados con la mastectomía, entre los que se incluyen la cirugía reconstructiva y las prótesis. De hecho, consideramos que esta atención es tan importante que el Fondo de Beneficios la cubría incluso antes de que lo exigiera la Ley de Derechos sobre la Salud y el Cáncer de la Mujer de 1998. Dependiendo de la recomendación de su médico, usted está cubierta para: • la reconstrucción del seno en que se realizó la mastectomía; • a cirugía y la reconstrucción del otro seno para lograr un aspecto simétrico; • prótesis; y • el tratamiento de las complicaciones físicas relacionadas con todos las etapas de la mastectomía, incluidos los linfedemas. Estos beneficios son proporcionados por el Fondo Nacional de Beneficios de 1199SEIU y el Fondo de Beneficios del Gran Nueva York de la 1199SEIU. La cobertura está sujeta a las reglas, exclusiones y limitaciones de los beneficios que pueden corresponder según el Plan, de acuerdo con lo que permita la ley.

Con la Pronta Llegada de la Temporada de Gripe, es la Prioridad Principal de Todos Mantenerse Saludables Vacunarse contra la gripe es una medida preventiva importante en este momento del año, particularmente para los trabajadores de la atención de la salud y para las personas que sufren de enfermedades crónicas como el asma. Puede parecer que es un poco temprano para pensar sobre cómo obtenerla, pero la temporada de la gripe está muy cerca. Este año podrá protegerse a sí mismo y a sus pacientes, si aprovecha las vacunas gratuitas contra la gripe que proporciona su empleador en su lugar de trabajo. Naturalmente, si su empleador no la ofrece, cuenta con la cobertura del Fondo de Beneficios, por lo que sólo debe programar una cita con su médico de atención primaria.

PA R A S U B E N E F I C I O

Perfil del Miembro

Acerca de sus beneficios

Maria Castaneda, Secretaria-Tesorera de 1199SEIU

La Nueva Ley de Reforma a la Salud Extiende la Cobertura para Usted y su Familia

PA R A S U B E N E F I C I O

Otoño de 2010

Protección de Nuestra Salud

DEDICADO A LA SALUD Y EL BIENESTAR DE LOS MIEMBROS DE 1199SEIU

Atentamente,

Mitra Behroozi Directora ejecutiva Fondos de Beneficios y Pensiones de 1199SEIU

PA R A S U B E N E F I C I O

Protección de Nuestra Salud

1199SEIU Nurse Helpline and Health Coaching Service

(866) 935-1199

Saturday, October 9 Healthy Meals in 30 Minutes Family Nutrition Workshop 10:30 am to 11:30 am All-Ages Exercise Class 11:45 am to 12:30 pm

Please call to reserve (646) 473-8960 option 2

Nutritional Content by Serving (estimated 1 cup cooked pasta) Calories 385 Carbs 51.1g Sodium 312mg Cholesterol 18.1mg Fiber 4.4g Fat 9.9g Saturated Fat 1.23g MUFA 5.3g PUFA 1.1g Protein 23g

FOR YOUR BENEFIT

Fitness Corner

Week

Walking Schedule* (brisk walking time, 3 days per week)

Weekly Total

1 2 3 4 5 6 7 8 9 10 11 12

5 minutes 7 minutes 9 minutes 11 minutes 13 minutes 15 minutes 18 minutes 20 minutes 23 minutes 26 minutes 28 minutes 30 minutes

15 minutes 21 minutes 27 minutes 33 minutes 39 minutes 45 minutes 54 minutes 60 minutes 69 minutes 78 minutes 84 minutes 90 minutes

Source: mayoclinic.com/health/walking/SM00060

How to Start a Walking Team •

Spread the word. Talk to friends, colleagues and family who might be ready to join you, or put up a notice in the Break Room.

•

Get organized. Hold a team kickoff meeting and collect contact information. Discuss how often to walk, what your routes will be and other details.

•

Once you begin walking, keep track of your progress and build momentum by logging your team's miles and times online.

•

Keep the interest alive. Look for ways to encourage each other to continue, such as walking for charities, giving your team a name or designing T-shirts.

So take the challenge: Create a walking team at your worksite with your colleagues and promote a culture of health. If you need help getting started, contact your Outreach Coordinator.

Beneficios, y traiga a toda la familia. I Aproveche las membresías con descuentos para los miembros de 1199SEIU en YMCA, New York

Sports Clubs y Crunch Fitness del Gran Nueva York. I Pase su día libre jugando frisbee, pateando una pelota de fútbol o caminando con su familia en su

PA R A S U B E N E F I C I O

La Esquina del Acondicionamiento Físico

Camine hacia una Mejor Salud

Semana Programa de caminata* (tiempo de caminata vigorosa, 3 días a la semana)

1 2 3 4 5 6 7 8 9 10 11 12

5 minutos 7 minutos 9 minutos 11 minutos 13 minutos 15 minutos 18 minutos 20 minutos 23 minutos 26 minutos 28 minutos 30 minutos

Total semanal

15 minutos 21 minutos 27 minutos 33 minutos 39 minutos 45 minutos 54 minutos 60 minutos 69 minutos 78 minutos 84 minutos 90 minutos

Fuente: mayoclinic.com/health/walking/SM00060

Cómo Crear un Equipo de Caminata •

Comente la idea. Converse con amigos, colegas y familiares que pudieran estar listos para unirse, o ponga un aviso en la sala de receso.

•

Organícense. Haga una reunión de inicio del equipo y recopile la información de contacto. Converse sobre la frecuencia con que saldrán a caminar, cuáles serán sus rutas y otros detalles.

•

Una vez que empiece a caminar, mantenga un registro de su progreso y motive al resto con un registro de las millas y los tiempos de su equipo en Internet.

•

Mantenga vivo el interés. Busque maneras de motivarse entre sí para continuar, como hacer caminatas de caridad, darle un nombre al equipo o diseñar camisetas.

Acepte el desafío: Cree un equipo de caminata en su lugar de trabajo con sus colegas y promueva una cultura de la salud. Si necesita ayuda para comenzar, comuníquese con su Coordinador de Ayuda.

New York Sports Clubs and Crunch Fitness I Spend your day off playing Frisbee, kicking a soccer ball or taking a walk with your family at your

local park.You can also join one of the inexpensive or free exercise classes offered at many of the New York City parks’ recreational facilities. Find one near you at www.nycgovparks.org.

FOR YOUR BENEFIT

Protecting Our Health

Eat a more plant-based diet that emphasizes vegetables, beans, whole grains, nuts and seeds •

Check out your local farmers market or Green Cart for seasonal fruits and vegetables (see p. 7)

•

Go vegetarian until dinner: Choose fruits, vegetables, low-fat yogurt and whole-grain cereals and breads for breakfast and lunch

Increase your intake of seafood and fatfree and low-fat milk and milk products •

Make a breakfast shake with fresh or frozen fruit and low-fat yogurt

•

Experiment with fish high in “good” omega-3 fatty acids like salmon and trout

Eat fewer foods that contain added sugars and solid fats •

Shop the perimeter: Choose the whole foods at the edge of your grocery store like fruits, vegetables, dairy and lean meats instead of the processed convenience foods in the center aisles

Reduce sodium • •

Eat fewer refined grains •

Make half your grains whole: Choose whole wheat over white bread, and brown or wild over white rice

Servicio de Entrenamiento de Salud y la Línea de Ayuda de Enfermería de 1199SEIU

Contenido Nutricional por porción (por aprox. 1 taza de pasta cocida)

Calorías 385 Carbohidratos 51.1g Sodio 312mg Colesterol 18.1mg Fibra 4.4g Grasas 9.9g Grasas saturadas 1.23g AGMI 5.3g AGPI 1.1g Proteínas 23g

PA R A S U B E N E F I C I O

Protecting Our Health

FOR YOUR BENEFIT

Member Profile

1199SEIU Secretary-Treasurer Maria Castaneda Lost 42 Pounds and Found a New, Healthier Way to Live

Her husband and daughter feel good, too, as they support Maria in her commitment to create a healthier lifestyle for all of them. These days, living that lifestyle comes naturally to her. She has much more energy than she used to have, she no longer craves ice cream or potato chips, and if she’s forced to skip a workout, she actually misses it. She explains, “If you exercise and you eat the good food that you want to eat, your whole attitude changes.” Sharing her story with her co-workers, the union’s officers and staff, Maria has been an inspiration to them as well. “They started organizing walking teams at night,” she said. “They started to also modify their meal intake, and they are telling me that they have lost weight, too.” Happy with her success – she’s also dropped five dress sizes and reduced her body-fat percentage from 41.6 to 31.6 – Maria points out that the Benefit Fund offers all members the resources they need to reach their own goals.“Our Benefit Fund has a wellness program that educates our members about healthy lifestyles and wellness,” she said. “To be true to our program, I wanted to do the same thing.”

Your child is disabled if the Trustees determine in their discretion that your child lacks the ability to engage in any substantial gainful activity due to any physical or mental impairment that is verified by a physician and is expected to last for a continuous period of not less than 12 months or result in death.

Like many women, Maria Castaneda has a demanding job, as 1199SEIU Secretary-Treasurer, and a busy home life that leaves her little time to exercise or prepare healthy meals. As a result, though only 5’4”, her weight rose to 172 pounds. She knew she had to change her habits, but she didn’t know where to begin. Finally, when she turned 54 on May 23, 2009, she gave herself a wonderful birthday present: a gym membership and a personalized training program.“I realized, I don’t want to be sick,” she said. “I want to have an active, healthy lifestyle when I retire, so I better take care of my health now and still have many, many years.” Now, at 130 pounds, Maria is committed to staying healthy. Not that it was easy at the beginning. “For the first month I did not lose any weight, so I was a little disappointed,” she said. “But some of my clothes started to fit better, so my trainer asked me to keep a log of the food I ate.”That’s when Maria noticed that the potato chips and ice cream and takeout food she loved were undoing all her hard work at the gym. So she made a second commitment to her health.“I said, Okay, no more takeout. Every weekend I plan our meals, do food shopping, eliminate the takeout,” she said.“I’m Filipino, so I cook Filipino food – one-dish meals with vegetables and protein. I choose foods that are simple to prepare but healthy. I feel good about the changes because I like the food I cook.”

QUALIFIED MEDICAL CHILD SUPPORT ORDER The Benefit Fund will comply with the terms of any Qualified Medical Child Support Order (QMCSO) as the term is defined in the Employee Retirement Income Security Act (ERISA) of 1974, as amended. A QMCSO may require the Benefit Fund to make coverage available to your child even though the child is not, for income tax purposes or Fund purposes, your legal dependent, because of separation or divorce.

In order to be a qualified order, the medical child support order must: • Be issued by a court or authorized state agency; • Clearly specify the alternate recipient; • Reasonably describe the type of coverage to be provided to such alternate recipient; • Clearly state the period to which such order applies; and • Indicate the name and last known address of the member who is required to provide the coverage and the name and mailing address of each child covered by the order. The Plan Administrator will determine the qualified status of a medical child support order in accordance with the Benefit Fund’s written procedures. * Effective January 1, 2011, the HealthCare Reform provisions on overaged dependents up until age 26 - discussed elsewhere in this magazine – will take effect. MEDICARE AND END STAGE RENAL DISEASE (ESRD) Effective September 21, 2009, the subsection entitled “Medicare and End Stage Renal Disease (ESRD), in Section I.F, is hereby replaced with the following: In the case of an individual entitled to Medicare benefits on the basis of end stage renal disease (ESRD), the Benefit Fund will be the primary payor of benefits only for the period required by law. Thereafter, the Benefit Fund will be secondary to Medicare. To protect your benefits, you must enroll in Medicare Part A and Part B immediately upon becoming entitled to Medicare benefits. The Fund will provide reimbursement for 50% of your Medicare Part B premium. You may file a claim form once each quarter to get this benefit. Effective December 11, 2008, the second paragraph of Section I.K, “Your COBRA Rights,” regarding domestic partners, is hereby omitted. Effective September 21, 2009, the first paragraph of Section I.I, “When Your Benefits Stop,” is replaced with the following: If you are no longer employed by a Contributing Employer, stop working or your employer is not obligated to make payments to the Benefit Fund on your behalf, all benefits end 30 days after the last day for which your employer is required to make contributions to the Benefit Fund* on your behalf unless your benefits are continued as described in Sections I.D and I.H or Section VI- Retiree Health Benefits. *This may include contributions for severance or other wages paid to you, such as vacation, etc.

Effective December 3, 2009, Section II. L is hereby replaced with the following:

Section II.L PRESCRIPTION DRUGS BENEFIT BRIEF Prescription Drugs • Coverage of FDA-approved prescription medications for FDA-approved indications, except plan exclusions • No co-payments, no deductible when you use generic drugs and preferred drugs where available • Use Participating Pharmacies • Mandatory maintenance drug access program • You must comply with the Benefit Fund’s Prescription Programs. For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Wage Class I: Family Wage Class II: Not Covered Wage Class III: Not Covered If you are in Wage Class I, you, your spouse and your children are covered for prescription drugs. If you are in Wage Class II or Wage Class III, you are not covered for this benefit. WHAT IS COVERED The Benefit Fund covers drugs approved by the Food and Drug Administration (FDA) that: • Have been approved for treating your specific condition; • Have been prescribed by a licensed prescriber; and • Are filled by a licensed pharmacist. Benefits for prescriptions for FDA-approved drugs that are not approved for treatment of your condition must be submitted to the Benefit Fund office for consideration. Your doctor should provide detailed medical information and supporting documentation for prescribing this medication. USING YOUR BENEFITS To get your prescription: • Ask your doctor to prescribe only covered medications, as per the Benefit Fund’s Prescription Programs; • Use Participating Pharmacies for short-term medications; and • Show your Health Benefits ID Card to the pharmacist when you give him or her your prescription. There is no out-of-pocket cost for your prescriptions if you comply with the Benefit Fund’s prescription programs: • Mandatory generic drug program; • Preferred Drug List; • Mandatory maintenance drug access program; • Prior authorization for specified medications; • Quantity and day supply limitations; • Step therapy; and • Use the Specialty Care Pharmacy for injectables and other drugs that require special handling. PRESCRIPTION DRUG PROGRAMS For a complete listing of these programs, please call the Benefit Fund at (646)473-9200 or visit our website at www.1199SEIUBenefits.org Generic Drugs Generic Drugs are the same as brand-name drugs. The only major difference is the cost. By law, generic drugs must contain the same active ingredients in the same quantities and be the same strength as the corresponding brand-name drug. Most importantly, they must meet the same FDA standards for safety and effectiveness. When your doctor gives you a prescription: • If there is a generic equivalent for a brand-name drug, you must get the generic drug. Otherwise, you will have to pay the difference in cost between the brand-name drug and the generic equivalent. • If there is no generic equivalent, your prescription will be filled with the brand-name drug. • In rare situations, your doctor may specify the brand-name drug.

PA R A S U B E N E F I C I O

PROTECT YOUR CARD

USE A PARTICIPATING PHARMACY For a listing of Participating Pharmacies, call the Benefit Fund’s Member Services Department at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org.

WHAT’S NOT COVERED The Benefit Fund does not cover:

FOR YOUR BENEFIT

Avoid Long Waits at the ER:

Some benefits may require prior authorization. Please refer to the sections describing those specific benefits for more information.

Use Our Benefit Funds’ Urgent Care Network

NEW YORK CITY EMPLOYEES

According to a new report by the American College of Emergency Physicians, New Yorkers wait an average of five hours when they visit hospital emergency departments. That’s one of the longest wait times in the nation!

Effective December 11, 2008, the definitions of “domestic partner” and “spouse” in Section IX are replaced with the following:

Remember, you and your family can avoid that frustration by visiting one of our participating Urgent Care or Walk-In Health Centers when you need care quickly. Urgent Care Centers and Walk-In Health Centers offer extended hours and treat urgent but non-emergency conditions like the flu, allergic reactions, and minor injuries and burns. And the staff at an Urgent Care or Walk-In Health Center will have more time to ask you about your medical history and answer your questions than a busy ER doctor. For a list of Urgent Care and Walk-In Health Centers convenient to you, go to www.1199SEIUBenefits.org. You can also access care without leaving your home by calling the 1199SEIU Nurse Helpline or a Health Coach at (866) 935-1199 for around-the-clock support, seven days a week, for answers to your questions.

• Over-the-counter drugs (except for diabetic supplies); • Over-the-counter vitamins; • Non-prescription items such as bandages or heating pads — even if your physician recommends them; • Prescriptions for drugs not approved by the FDA for the treatment of your condition; • Cost differentials for drugs that are not approved through the Benefit Fund’s Prescription Drug Program; • Experimental drugs; • Non-sedating antihistamines; • Migraine medication in excess of FDA guidelines for strength, quantity and duration; • Medications for cosmetic purposes; • Proton pump inhibitors in excess of a 90-day supply for FDA-approved indications by diagnosis; • Biotechnology drugs above the $100,000 limit; • Cold and Cough Prescription products; • Oral Erectile Dysfunction agents (except for penile functional rehabilitative therapy for up to six-months immediately following prostatic surgery); and • All general exclusions listed in Section VII.D.

Same-sex Partner (formerly “domestic partner”) The individual with whom you are in a same sex partner relationship which meets the criteria set forth in Section 1.A. Spouse The person to whom a member is legally married and who is eligible for benefits from the Benefit Fund as described in Section 1.A. Generally, wherever the term “your spouse” is used in this booklet, it is intended to refer to your same-sex partner as well, except where noted otherwise or the context would indicate such usage was not intended. Effective September 21, 2009, the sixth bullet point in Section VII.D, “What is Not Covered,” is hereby replaced with the following: • To the extent permitted by law, charges related to an illness or injury: o That was deliberately self-inflicted except where such illness or injury is attributable to a mental condition, or o That resulted from the person committing an illegal act ________________________________________________ This summary only highlights the key changes made to the 1199SEIU National Benefit Fund for Health & Human Service Employees. Summaries of material modifications together with the Summary Plan Description make up your official plan descriptions; please keep them together and refer to them as necessary. We have made every attempt to insure the accuracy of the information in this summary and the Summary Plan Description. However, if there is any discrepancy between them and the plan document, insurance contracts or other legal documents, the legal documents will always govern. If you would like to review the plan document or have any questions, please contact the Fund’s Member Services Representatives at (646) 473-9200. The Fund believes it is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your this plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for an external review process for claims appeals. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

Questions regarding the Fund's status as a grandfathered health plan can be directed to the Fund at 646-473-9200. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans. The plan sponsor of the1199SEIU National Benefit Fund for Health & Human Service Employees reserves the right to amend or terminate the 1199SEIU National Benefit Fund for Health & Human Service Employees, or any part of it, at any time.

1199SEIU GREATER NEW YORK BENEFIT FUND SUMMARY OF MATERIAL MODIFICATIONS This Summary of Material Modifications describes changes that affect your job security benefit plan and updates the Summary Plan Description (“SPD”) that was previously distributed to you. You should keep this summary with your SPD until the SPD is updated to reflect the changes discussed herein. _________________________________________ The following subsections of Section I. A of the SPD, entitled “Your Children” and “After Your Child Reaches Age 19,” are hereby replaced with the following, respectively: YOUR CHILDREN * Your children are eligible up to their 19th birthday if all the following conditions are met: • They’re your biological children; or • They’re your legally adopted children (coverage for legally adopted children starts from placement); or • You are their legal parent identified on their birth certificate; and • They are dependent on you for their full support and are living permanently with you, or an appropriate court issues a qualified medical child support order which provides otherwise (see box in Section I.A); • They’re not married; and • You are eligible for family coverage, based on your Eligibility Class (see Section I.D). Your stepchildren, foster children and grandchildren are not covered by the Benefit Fund. AFTER YOUR CHILD REACHES AGE 19 (effective January 1, 2010) Your child’s coverage may be continued from your child’s 19th birthday up to his or her 23rd birthday if: • He or she is a full-time matriculated student attending high school or college, not married, not working full-time, living at home or school, and totally dependent on you for support (“totally dependent”); and • You file a properly completed Dependent Recertification Form, along with proof that your child is a full-time student, with the Benefit Fund when your child turns age 19 and each year after that until your child’s 23rd birthday. Your child is not a dependent if he/she: • Lives outside of the United States; or • Is in the military or similar forces of any country or subdivision thereof. EXTENSION OF COVERAGE FOR STUDENTS UNDER MICHELLE’S LAW If your totally dependent child who is enrolled full-time in high school or college takes a medically necessary leave of absence due to a serious illness or injury and the Benefit Fund has received written certification of the medical necessity by his or her treating physician, your child’s coverage may be continued for up to one year after the first day of the leave of absence or the date coverage would otherwise terminate under the terms of the Benefit Fund (if earlier) (for instance, upon your child’s 23rd birthday). Effective September 21, 2009, the first paragraph of Section I.I, “When Your Benefits Stop,” is replaced with the following: If you are no longer employed by a Contributing Employer, stop working or your employer is not obligated to make payments to the Benefit Fund on your behalf, all benefits end 30 days after the last day for which your employer is required to make contributions to the Benefit Fund* on your behalf unless your benefits are continued as described in Section I.J or Section VI- Retiree Health Benefits.

PA R A S U B E N E F I C I O

About Your Benefits

* Effective January 1, 2010 the HealthCare Reform provisions on overaged dependents up until age 26 - discussed elsewhere in this magazine - take effect).

FOR YOUR BENEFIT

drugs above this limit will be considered to the extent that there are payments for such drugs available from other sources.

MESSAGE FROM THE EXECUTIVE DIRECTOR

10 Walking Yourself to Better Health

So be sure to take full advantage of all the benefits your Funds offer. And as always, we hope you find the news in your member magazine helpful and informative.

11 Nurse Helpline Provides 24-Hour Support

Sincerely,

Mitra Behroozi Executive Director 1199SEIU Benefit and Pension Funds

WHAT’S NOT COVERED The Benefit Fund does not cover: • Over-the-counter drugs (except for diabetic supplies); • Over-the-counter vitamins; • Non-prescription items such as bandages or heating pads — even if your physician recommends them; • Prescriptions for drugs not approved by the FDA for the treatment of your condition; • Cost differentials for drugs that are not approved through the Benefit Fund’s Prescription Drug Program; • Experimental drugs; • Non-sedating antihistamines; • Migraine medication in excess of FDA guidelines for strength, quantity and duration; • Medications for cosmetic purposes; • Proton pump inhibitors in excess of a 90-day supply for FDA-approved indications by diagnosis; • Biotechnology drugs above the $100,000 limit; • Cold and Cough Prescription products; • Oral Erectile Dysfunction agents (except for penile functional rehabilitative therapy for up to six-months immediately following prostatic surgery); and • All general exclusions listed in Section VII.D. Some benefits may require prior authorization. Please refer to the sections describing those specific benefits for more information. NEW YORK CITY EMPLOYEES

You will only be reimbursed up to the Benefit Fund’s Schedule of Allowances. FILLING YOUR PRESCRIPTIONS For Short-Term Illnesses: If you need medication for a short period of time, such as an antibiotic, go to your local Participating Pharmacy to have your prescription filled. For Chronic Conditions: The Fund’s Mandatory Maintenance Drug Access Program – The 90-Day Rx Solution If you have a chronic condition and are required to take the same medication on a longterm basis, you must fill your prescription through the Benefit Fund’s mandatory maintenance drug access program, The 90-Day Rx Solution. This program requires that you order medications that you take on an ongoing basis in 90day supplies. For your convenience, your medication will be delivered directly to you at your choice of address. If you live in New York or New Jersey, you may choose to order and pick up your 90-day supply at a designated participating pharmacy. If you are currently taking a maintenance medication, ask your doctor for a 90-day prescription (with 3 refills) and fill it either by: • Mailing the prescription to the Benefit Fund’s mail order pharmacy, where it will normally be delivered within eight days; or • Taking it to one of the designated pharmacies in New York or New Jersey. For new maintenance medications, ask your doctor for two prescriptions: one for a 30-day supply (with one refill) and another for a 90-day supply (with 3 refills) that can be filled through the maintenance drug access program once you know that the medication works for you. Call the Benefit Fund at (646) 473-9200 or visit our website at www.1199SEIUBenefits.org for the locations of pharmacies that participate in the maintenance drug access program, for a mail order form or to determine if the drug that you are taking is a maintenance medication.

11 Staying Healthy Is Fun When It’s a Family Affair

use their primary prescription insurer first. Participating Pharmacies will not fill prescriptions for your spouse through the use of this Health Benefits ID card.

For New York City employees, certain classes of drugs will be covered through the health program provided to you through the City and not covered through the NBF prescription benefit. For a listing of these drugs, please contact the Benefit Fund’s Prescription Department. Effective September 21, 2009, the sixth bullet point in Section VII.D, “What is Not Covered,” is hereby replaced with the following: • To the extent permitted by law, charges related to an illness or injury: o That was deliberately self-inflicted except where such illness or injury is attributable to a mental condition, or o That resulted from the person committing an illegal act __________________________________________ This summary only highlights the key changes made to the 1199SEIU Greater New York Benefit Fund. Summaries of material modifications together with the Summary Plan Description make up your official plan descriptions; please keep them together and refer to them as necessary. We have made every attempt to insure the accuracy of the information in this summary and the Summary Plan Description. However, if there is any discrepancy between them and the plan document, insurance contracts or other legal documents, the legal documents will always govern. If you would like to review the plan document or have any questions, please contact the Fund’s Member Services Representatives at (646) 473-9200. The Fund believes it is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your this plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for an external review process for claims appeals. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits. Questions regarding the Fund's status as a grandfathered health plan can be directed to the Fund at 646-473-9200. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans. The plan sponsor of 1199SEIU Greater New York Benefit Fund reserves the right to amend or terminate the 1199SEIU Greater New York Benefit Fund, or any part of it, at any time.

PA R A S U B E N E F I C I O

1199SEIU Benefit and Pension Funds 330 West 42nd Street New York, NY 10036-6977 www.1199SEIUBenefits.org ADDRESS SERVICE REQUESTED

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DEDICATED TO THE HEALTH & WELL-BEING OF 1199SEIU MEMBERS

FALL 2010

For Your Benefit

A Magazine Devoted to the Health & Well-Being of 1199SEIU Members EN ESPAÑOL p12

Finding a healthier way to live! SAVOR Fall’s Seasonal Fruits and Vegetables New HEALTH Law Brings Changes