Labor unions that represent health care workers encounter unique circumstan
ces. This study focuses on 1199-the largest health care workers' union in t
he United States, based in New York City-and describes how the union and it
s National Benefit Fund have structured a managed indemnity health insuranc
e program that provides extensive benefits for its members. The authors det
ail the workings of the National Benefit Fund and the ways in which it can
improve the health care of its members through its union structure. The Fun
d represents a model for improving the provision of health care to American
s.