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.

Download an Upgrading Application (pdf)

Download Form - PDF

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 Health & Benefits Plan Under 26 Dependent Enrollment Form

Download Form - PDF

 

Seafarers Health & Benefits Plan Sickness & Accident Application

Download Form - PDF

Prescription Solutions Direct Member Reimbursement Form

Download Form - PDF

 

Seafarers Plans E-Mail Communication Consent Form

Download Form - PDF

Seafarers Death Benefit Application (Retirees)

Download Form - PDF

Seafarers Death Benefit Application (Actives)

Download Form - PDF

Vacation Applications

Download Form - PDF

Vacation Applications (Inland)

Download Form - PDF

 

Seafarers Money Purchase Pension Plan Enrollment Form and Designation of Beneficiary Form

Download Form - PDF

Seafarers Money Purchase Pension Plan Application for In-Service Pension Benefits or Required Minimum Distributions

(In the “print” dialogue box, click on "Choose paper source by PDF page size" and select Legal for

page size so the document prints properly.)

Download Form - PDF

Seafarers Money Purchase Pension Plan Application for Death Benefits

(In the “print” dialogue box, click on "Choose paper source by PDF page size" and select Legal for page size so the document prints properly.)

Download Form - PDF

Seafarers Money Purchase Pension Plan Application for Pension Benefits

(In the “print” dialogue box, click on "Choose paper source by PDF page size" and select Legal for

page size so the document prints properly.

Download Form - PDF