Survey

Yes! I want to join my SEIU Healthcare 1199MW co-workers in signing on to our group grievance to fix our retiree medical insurance payout. By filling out this form, I am authorizing my name to be added to the grievance that will be submitted to Group Health Cooperative management.

We are grieving violations including but not limited to Section 12.6 of our contract, Retiree Medical Coverage, and Addendum 7, the Retiree Medical Charts. We are seeking to be made whole in every way, including but not limited to receiving the payout amounts listed in the charts in Addendum 7, based on our age and years of service as of December 31, 2009, in our 403(b) accounts by March 31, 2010.

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1. By completing the information below, I authorize my name to be added to the grievance on Retiree Payout Benefits.

By completing the information below, I authorize my name to be added to the grievance on Retiree Payout Benefits. First Name:
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*1. By completing the information below, I authorize my name to be added to the grievance on Retiree Payout Benefits.

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1. By completing the information below, I authorize my name to be added to the grievance on Retiree Payout Benefits.