Applications

Seafarers Harry Lundeberg School of Seamanship:

  • Download an Upgrading Application (PDF)

Seafarers Pension Plan:

  • Seafarers Pension Plan Application (PDF)
    (In the “print” dialogue box, in the upper right corner under “Properties,” please select Legal for page size so the document prints properly.)
  • Seafarers Death Benefit Application (Retirees) (PDF)
  • SHBP / SPP / SMPPP Letter and Form re Electronic Consent for Delivery of Plan Documents (PDF)
  • SPP Beneficiary Form (PDF)
  • SPP Annuity Certification Form (PDF)

Seafarers Health and Benefits Plan:

  • SHBP Enrollment Form (PDF)
  • Seafarers Health & Benefits Plan Sickness & Accident Application (PDF)
  • OptumRx Direct Member Reimbursement Form (PDF)
  • Seafarers Death Benefit Application (Actives) (PDF)
  • SHBP Nicotine Replacement Therapy Reimbursement Form for Puerto Rico / Humana participants only (PDF)
  • SHBP / SPP / SMPPP Letter and Form re Electronic Consent for Delivery of Plan Documents (PDF)
  • SHBP / SMPPP / SVP Beneficiary Form (PDF)

Seafarers Vacation Plan:

  • Vacation Application (PDF)
  • Vacation Application (Inland) (PDF)
  • SVP / SMPPP Deduction Authorization Form (allows SVP to deduct participant’s SMPPP voluntary contribution from Vacation Benefit) (PDF)
  • SHBP / SMPPP / SVP Beneficiary Form (PDF)

Seafarers Money Purchase Pension Plan (SMPPP):

  • SMPPP Application for Pension Benefit (Form HBP 026; 01/17) (PDF)
  • SMPPP Qualified Joint & Survivor Annuity Inquiry Form (Form HBP 057 02/17) (PDF)
  • SMPPP Qualified Joint & Survivor Annuity Notice 01/17) (PDF)
  • SMPPP Application for Death Benefit (Form HBP 028; 01/17) (PDF)
  • SMPPP Special Tax Notice – Employer Contribution Account (08/2018) (PDF)
  • SMPPP Special Tax Notice – Voluntary Contribution Account (08/2018) (PDF)
  • SMPPP Death Benefit Tax Explanation Notice (PDF)
  • SHBP / SPP / SMPPP Letter and Form re Electronic Consent for Delivery of Plan Documents (PDF)
  • SVP / SMPPP Deduction Authorization Form (allows SVP to deduct participant’s SMPPP voluntary contribution from Vacation Benefit) (PDF)
  • SHBP / SMPPP / SVP Beneficiary Form (PDF)