Prescription Benefit for National Benefit Fund Members

Change to CVS Caremark

Your Fund has changed pharmacy benefit managers from Express Scripts to CVS Caremark effective July 1, 2024. Visit the 1199SEIU CVS Caremark member portal at

The Preferred Drug List (PDL)

Have your doctor prescribe preferred drugs on the 1199SEIU Preferred Drug List (PDL). Share this list with your doctor and work together to find the best covered option for you. If your doctor prescribes a drug in a category covered by the Benefit Fund but you don’t see it on the Preferred Drug List, just ask your doctor to prescribe any generic medication or a brand-name if there are no generics available.

The 90-Day Rx Solution

Fill long-term medications through The 90-Day Rx Solution, the Benefit Fund’s maintenance drug program. Ask your doctor to write your prescription for a three-month supply with three refills (a year’s supply in total), and fill it through CVS Specialty, or order and pick up your prescription at any CVS, Rite Aid, Walgreens or Duane Reade pharmacy nationwide.

Participating Pharmacies

Fill short-term prescriptions at participating pharmacies.

Prior Authorization

Some medications and services require prior authorization. If your doctor thinks you need a medication that is not on the Preferred Drug List, call CVS Caremark at (833) 250-3237 or CVS Specialty at (855) 299-3262.

Specialty, Step Therapy and Quantity Duration Drugs

In order to continue to safeguard your health while providing you access to the medications you need, we use prescription programs such as our specialty medications list and drug quantity management drug list.

Who Is Eligible?

Family Coverage — Wage Class I

Wage Class II and III are not covered

Not Sure What Wage Class You Are?

Check the front of your Health Benefits ID Card, or click here for an explanation.

Additional Resources

Reimbursement for Drugs Purchased on or Before June 30, 2024

Use the Express Scripts Direct Claim Reimbursement Form for drugs purchased on or before June 30, 2024. For purchases on or after July 1, 2024, use the related CVS Caremark form above.

Your Benefits

Medical Benefit

Access to more than 30,000 Benefit Fund providers throughout New York City, Westchester and Long Island.

Mental and Behavioral Health

Comprehensive support through talk therapy, inpatient and outpatient treatment programs and coordinated care.

Prescription Benefit

Full prescription coverage with no co-payments when you use preferred drugs where available.

Dental Benefit

A choice of two plans—EmblemHealth or Aetna DMO—providing basic care, including cleanings, exams and restorative services.

Vision Benefit

Eye exams and glasses or contact lenses every two years.

Life Insurance

Life insurance benefit based on Wage Class.

Keeping Your Coverage

COBRA Continuation Coverage

COBRA allows you to extend your health benefits when your Benefit Fund coverage ends due to a “qualifying event.”


This benefit provides a financial cushion if you are temporarily unable to work due to non-work-related accidents, injury or illness. 

Paid Family Leave

New York State’s Paid Family Leave (PFL) benefit is administered at no cost to NBF members.

Workers' Compensation

Provided through your employer, this benefit provides health and wage benefits if you are injured or become ill at work.