Benefits Applications


NOTICE: Members will need Adobe Acrobat Reader to make use of these .pdf format benefits applications. If you experience difficulties trying to print these documents, try saving them directly to your hard drive and open/print from there. Download Adobe Acrobat Reader here.

 

Seafarers Harry Lundeberg School of Seamanship:


Download an Upgrading Application (pdf)

Download Form - PDF


Seafarers Pension Plan:


Seafarers Pension Plan Application

(In the “print” dialogue box, in the upper right corner under “Properties,” please select Legal for page size so the document prints properly.)

Download Form - PDF

 

Seafarers Death Benefit Application (Retirees)

Download Form - PDF

 

Seafarers Health and Benefits Plan:

 

Seafarers Health & Benefits Plan Sickness & Accident Application

Download Form - PDF

OptumRx Direct Member Reimbursement Form

Download Form - PDF

 

Seafarers Death Benefit Application (Actives)

Download Form - PDF

 

Seafarers Vacation Plan:


Vacation Applications

Download Form - PDF


Vacation Applications (Inland)

Download Form - PDF

 

Seafarers Money Purchase Pension Plan (SMPPP):

 

SMPPP Application for Pension Benefit (Form HBP 026; 01/17)

Download Form - PDF

 

SMPPP Designation of Beneficiary Form (Form HBP 041; 01/17)

Download Form - PDF

 

SMPPP Qualified Joint & Survivor Annuity Notice 01/17)

Download Form - (PDF)

 

SMPPP Application for Death Benefit (Form HBP 028; 01/17)

Download Form - PDF

 

SMPPP Special Tax Notice - Employer Contribution Account

Download Form - PDF

 

SMPPP Special Tax Notice - Voluntary Contribution Account

Download Form - PDF

 

SMPPP Death Benefit Tax Explanation Notice

Download Form - PDF