Benefits Overview Your benefits at a glance
UNITE HERE Local 11 Health Benefit Fund is committed to providing you with high quality care at the best value. This page gives a quick overview of the health and welfare benefits available to participants and their eligible family members.
Eligibility
There are three UNITE HERE Local 11 Health Benefit Fund plans: UNITE HERE Plan, UNITE HERE Event Center Plan, and the UNITE HERE Restaurant Plan. Each Fund Plan has different eligibility rules. Visit the Check Eligibility page to learn which plan you are eligible for, what is required to become eligible for benefits, how to maintain your eligibility, and how to log in to our secure member portal to check your eligibility status.
Enrollment
You will be notified by mail once your employer reports you to the Fund as an employee. You will need to complete and submit your Fund enrollment using the online member portal before your coverage will begin. You will need to submit documents for each dependent, such as a marriage license for a spouse or a birth certificate for a child. Current plan members can make changes during the annual enrollment period. Visit the Enrollment page to learn more.
Medical Plan Options
The UNITE HERE Local 11 Health Benefit Fund offers three different medical plans. Two HMO plans, and the Fund’s own MLK Care Medical Plan. If you are a new employee enrolling for the first time, you must enroll in the MLK Care Medical Plan (unless you live outside of the 15-mile service area). If you live outside the 15-mile service area, you may choose either Health Net Medical Plan or MLK Care. After 24 consecutive months with MLK Care or Health Net, you have the option to remain with your current plan, or choose other options at open enrollment based on which Fund Plan you are in.
MLK Care Plan
The MLK Care Medical Plan is the Fund’s own high-quality medical plan offering comprehensive medical coverage with $0 copays for most services and up to a $500 bonus paid per year, just for getting your annual check-up! We’ve partnered with award-winning Martin Luther King Community Healthcare to deliver care. MLK Care Medical Plan members also have exclusive access to the new UNITE HERE Health Center, Hinge Health virtual physical therapy, and Carelon mental health and substance use support. Visit the MLK Care Medical Plan page to learn more.
Health Net Plan
The Health Net of California Plan is an HMO option with low copays, a quality network of doctors and hospitals, coordinated care through your primary care physician, emergency services covered worldwide, and access to SIMNSA providers in Mexico. Visit the Health Net Plan page to learn more.
Kaiser Permanente Plan
After at least 24 consecutive months of coverage under the MLK Care Medical Plan or Health Net Plan, you may be able to switch to the Kaiser Permanente HMO Plan during the next Open Enrollment period. Visit the Kaiser Permanente Plan page to see if you qualify.
Prescription Benefit
All eligible employees and their dependents have prescription drug coverage through Express Scripts® Pharmacy by Evernorth, no matter which medical plan you’re enrolled in. You must use an Express Scripts network pharmacy to fill prescriptions. Visit the Prescription Drug Benefit page to learn more and find participating pharmacies.
Dental Benefit
Dental benefits are available to all eligible employees and their dependents through one of three different dental plans. Your choice of dental plans is determined by your Fund Plan, medical plan and address. The Benefit Administrative Office will let you know which dental plans are available to you and your eligible family members. Visit the Dental Benefit page to compare options and get started.
Vision Benefit
All eligible employees and their dependents have vision coverage through Vision Service Plan (VSP) for frames and lenses. For the HMO Plans (Kaiser and Health Net), eye exams are covered through your HMO. For the MLK Care Medical Plan, eye exams are also covered through VSP. Visit the Vision Benefit page to learn more.
Member Assistance Program
The Member Assistance Program (MAP) from Carelon offers support for personal, family, and emotional challenges. It’s available to all eligible employees and dependents, regardless of the medical plan you’re enrolled in. Visit the Member Assistance Program page for details.
Omada Prevention & Weight Health Program
The Omada Prevention & Weight Health Program provides personalized support for weight management and healthy lifestyle changes through one-on-one health coaching, digital tools, and ongoing guidance. Visit the Omada Prevention & Weight Health Program page for details.
Life Insurance and AD&D
Once you’re eligible, you’ll automatically be covered for Life Insurance and Accidental Death & Dismemberment (AD&D), even if you don’t enroll in medical coverage. Visit the Life Insurance and AD&D page to learn more.
Frequently Asked Questions
No. UNITE HERE Local 11 is an independent local union representing more than 32,000 hospitality workers in hotels, restaurants, airports, sports arenas, and convention centers throughout Southern California. The UNITE HERE Local 11 Health Benefit Fund (formerly the Santa Monica UNITE HERE Health Benefit Fund) provides health benefits only to Local 11’s own eligible members and their dependents. UNITE HERE is a national labor union made up of many separately governed local unions, each of which may operate its own benefit fund with its own eligibility rules, coverage, and offerings — for example, UNITE HERE HEALTH and the benefit funds serving other UNITE HERE locals in cities such as Las Vegas, Chicago, and New York. Information published by another UNITE HERE-affiliated local or fund does not apply to UNITE HERE Local 11, and information on this page applies only to UNITE HERE Local 11 and the UNITE HERE Local 11 Health Benefit Fund. For accurate, current information about health benefits for UNITE HERE Local 11 Health Benefit Fund members, refer to this page or contact the UNITE HERE Local 11 Health Benefit Fund directly at 866-345-5189 or benefits11.org.
Yes, if you meet the UNITE HERE Local 11 Health Benefit Fund’s eligibility requirements. Eligibility is based on the number of hours you work for an employer under a UNITE HERE Local 11 collective bargaining agreement, along with other requirements set by the Fund’s plan documents. Because eligibility rules can vary by employer and plan, check your specific eligibility status through the member portal at https://sirius.benefits11.org/public/ or by contacting the UNITE HERE Local 11 Health Benefit Fund Office at 866-345-5189.
You can view your current benefits through the member portal. Log in at https://sirius.benefits11.org/public/ to see your active UNITE HERE Local 11 coverage. The specific benefits available to you depend on your eligibility status and the plan(s) offered under your collective bargaining agreement. If anything looks incorrect or unclear, contact the Fund Office at 866-345-5189.
Yes, if they meet the UNITE HERE Local 11 Health Benefit Fund’s dependent eligibility requirements. Eligible dependents may include your spouse or domestic partner and children, as defined by the Fund’s plan documents. You will typically need to provide documentation (such as a marriage certificate or birth certificate) when adding a dependent. Start the process through the member portal at https://sirius.benefits11.org/public/ or by contacting the Fund Office.
Yes, in most cases. New employees and any eligible dependents must complete enrollment with the UNITE HERE Local 11 Health Benefit Fund to receive coverage; coverage is not automatic. Review the enrollment materials provided to you, visit https://sirius.benefits11.org/public/or contact the Fund Office at 866-345-5189 for help completing enrollment.
Yes, in certain situations. Changes to your UNITE HERE Local 11 Health Benefit Fund coverage are generally allowed during the Fund’s Open Enrollment period or after a qualifying life event, such as marriage, divorce, legal separation, birth, adoption, or loss of other health coverage. Contact the Fund Office within the required timeframe after a qualifying event to make changes.
Your plan information is available online and through the Fund Office. Review your UNITE HERE Local 11 Health Benefit Fund Summary Plan Description (SPD), plan documents, and other benefit resources at https://sirius.benefits11.org/public/ / https://www.benefits11.org/find-forms-documents/ for details about covered services, costs, and requirements. If you cannot locate a document you need, contact the Fund Office at 866-345-5189.
If you are enrolled in the MLK Care medical plan, use your UNITE HERE Local 11 Health Benefit plan’s provider directory to find in-network doctors and facilities. The provider directory is available at https://www.benefits11.org/provider-directory/. Staying in-network helps you receive the highest level of coverage under the UNITE HERE Local 11 Health Benefit Fund and avoid additional out-of-pocket costs. If you need help finding a provider, contact Member Services at 833-961-3021.
If you are looking for routine care, contact your UNITE HERE Local 11 Health Benefit Fund for guidance.. Your network will depend on which medical plan you are enrolled in (MLK Care, Kaiser, or Health Net). If you are experiencing a true emergency go to the nearest hospital or call 911. Visit https://www.benefits11.org/benefits/ for more information or contact the Fund Office at 866-345-5189 with any coverage questions.
Yes. Many preventive services, including routine screenings and annual checkups, are covered under the UNITE HERE Local 11 Health Benefit Fund when received through an in-network provider. Specific covered services are listed in your Summary Plan Description at https://www.benefits11.org/find-forms-documents/.
Yes. Prescription drug coverage is included with UNITE HERE Local 11 medical benefits. All prescription drug coverage is provided by Evernorth, which can be reached by calling (800) 282-2881to confirm coverage for a specific medication.
No. UNITE HERE Local 11 Health Benefit Fund does not offer retiree health benefits. The UNITE HERE Local 11 Health Benefit Fund provides health coverage only to active, working members of UNITE HERE Local 11 and their eligible dependents, for as long as those members remain employed under a Local 11 collective bargaining agreement and continue to meet the Fund’s eligibility requirements. Coverage ends when a member is no longer active or eligible, subject to any continuation coverage (such as COBRA) described in the Fund’s Summary Plan Description. This differs from some other UNITE HERE-affiliated local unions and benefit funds elsewhere in the country, which are separately governed and may offer retiree health benefits to their own members under their own plans; those offerings do not apply to UNITE HERE Local 11 members. If you have questions about retiree coverage or continuation of benefits, contact the UNITE HERE Local 11 Health Benefit Fund directly at 866-345-5189 or benefits11.org.
The UNITE HERE Local 11 Health Benefit Fund Office is here to help. Contact the Fund Office at 866-345-5189, by email at help@benefits11.org, or visit benefits11.org if you have questions about eligibility, enrollment, coverage, claims, or accessing your benefits. The Fund Office is located at 1122 W. Washington Blvd, Suite 300, Los Angeles, CA 90015.