Hospital Grant for Mortgage, Supplemental Insurance or Retiree Healthcare Program Participants
- You must be a participant in at least one of the following programs for the amount of time specified below and your account or policy must be in good standing:
- Union Plus Mortgage - for at least 12 months
- Union Plus Life or Accident Insurance - for at least 12 months
- Union Plus Retiree Healthcare - for at least 12 months
- You must complete the required application and provide documentation that you or a member of your household had unreimbursed hospital expenses that:
- Are associated with a hospitalization event(s) that took place during the 12 month period prior to the date that you submit an application for a Hospital Grant; and
- Are equal to 10% of your annual household income.
- You must provide documentation of your annual household income by supplying your most recent W-2 Forms or pay stubs covering the applicable period.
- You must provide the applicable hospital and insurance statements that document:
- The dates and charges for the hospitalization ("Hospital Charges")
- The amount of the Hospital Charges covered by insurance; and
- The amount of Hospital Charges for which the patient was financially responsible.
- You may only receive one Hospital Grant for any one Union Plus Mortgage or Union Plus Life/Accident Insurance account.
Eligible Hospital Expenses
- When you calculate your out-of-pocket hospital expenses, you may include the insurance deductibles, any hospital charges, physician charges, medications and other medical expenses incurred during the hospitalization.
- Include only those hospital expenses related to an event resulting in hospitalization that occurred within 12 months prior to your application.
- Do not include expenses that were covered by your (or your spouse/dependent's) health insurance.
- Do not include expenses from care before or after the time of hospitalization.
- Unreimbursed expenses must total at least 10% of your annual household income.
How to Apply
- Collect and copy the required documentation:
- Documentation for your income (tax return(s) or W-2s for the last year)
- Hospital bills, insurance Explanation of Benefit (EOB) forms. Make sure you have documentation for all periods of hospitalization and explanation of insurance benefits for all coverage you received.
- Complete the online application form.
- Print your confirmation email and sign anywhere on the page that includes your application information.
- We encourage you to email in your application and documents if you are able to email@example.com or you may also fax them to our secure fax line at 866-481-5568.
However, if you are unable to use either of those means of getting your application to us, please mail all required documentation to:
Union Plus Hospital Grant
1100 First St. NE, Suite 850
Washington, DC 20002
Please note: Due to the current staffing conditions caused by the coronavirus (COVID-19) pandemic, applications mailed to our office may see a significant delay in processing time. For this reason, we strongly encourage the digital submission of paperwork.
- Please allow 6-8 weeks for application processing. You will be notified by mail when your application has been approved or denied.
- If approved for the grant, payment will be made by check and mailed directly to you.
- Please do not send originals. Documents will not be returned to you.
- All documents should be copied onto 8.5" x 11" paper.
- Only copy/print one side of paper.
- Please do not use staples or fasteners.
Please note: Failure to comply with these instructions will result in significantly delayed processing time.
Grants valued at $600 or more may be considered taxable income by the Internal Revenue Service. Therefore, a Form 1099-MISC tax reporting form, which will require your social security number, will be issued to each recipient of grants valued at $600 or more. If the required documentation you submitted does not contain this information, we will contact you to complete a W-9 form. Please keep your eye on your email inbox for this important request.