Benefit Fund Enrollment

To receive benefits, you must complete a FA Benefit Fund Enrollment Card. This card may be obtained from the Fund Office in Southampton 224D, Ammerman Campus, 533 College Road, Selden NY 11784.

Once you become enrolled, it is important that you notify the Fund Office, in writing, of any changes in your marital or family status and any change of your address. Payment of benefits can be put in jeopardy if the covered member fails to notify the FA Benefit Fund of subsequent changes in marital status or change of dependent status or domicile, or neglects to confirm college-attendance status of a dependent child of their household. 

Proof of a change in marital status must be provided by sending either a copy of your divorce decree/judgment, signed by a judge, or your marriage certificate to the Fund office. Once the FA Benefit Fund receives the proof, you must complete a new Enrollment Card. You may also wish to complete a new designation of beneficiary form for the FA Benefit Fund’s Burial Benefit and Life Insurance Benefit and any other benefits which may become payable upon your death. The provision of the divorce decree/judgment may not affect the designation of your former spouse on the beneficiary card for these benefits, irrespective of what the judge has ordered or the parties have agreed to. You must complete, sign, and file with the Fund Office a new Enrollment Card in order to change your beneficiary designation. Only those beneficiaries listed on a covered member’s duly executed designation of beneficiary card will be entitled to receive the appropriate benefits.