Forms for Employers
Disability
The Disability Part C form is now an online process in the Employer Services Account. We are currently training employers on the recently added Employment Events Module that allows you to submit Disability and Life Event information. For questions, or to schedule training, please contact EmployerServices@1199funds.org.
National Benefit Fund
- Enrollment Form
- Enrollment Change Form
- Pension Enrollment Form
- Paid Family Leave Form — Bond with a Newborn, Newly Adopted or Fostered Child
- Paid Family Leave Form — Care for a Family Member with a Serious Health Condition
- Paid Family Leave Form — Military Qualifying Event
- Paid Family Leave Flyer
Greater New York
- Greater New York Benefit Fund Enrollment Form
- Greater New York Benefit Fund Enrollment Change Form
- Greater New York for New Jersey Benefit Fund Enrollment Form
- Greater New York for New Jersey Benefit Fund Enrollment Change Form
- Greater New York Benefit Fund Spouse Coverage and Payroll Deduction Authorization Form
- Greater New York for New Jersey Benefit Fund Spouse and Child Coverage and Payroll Deduction Authorization Form