FAQs

If you are a bargained employee, your coverage begins on the first day of the month, following a period of at least six consecutive months, but not exceeding nine consecutive months (excluding January, February, and March), in which you are credited with at least 600 hours of Employer contributions. Once you become eligible, you remain eligible for at least three consecutive months.

You must work at least 250 hours during a “Contribution Quarter” to be eligible for health benefits during the “Corresponding Benefit Quarter”. The following chart shows Contribution Quarters and their Corresponding Benefit Quarters.

If you do not work at least 250 hours during a Contribution Quarter, we will automatically look at your work hours for which required employer contributions were made during the current and previous quarters. You will be eligible during Corresponding Benefit Quarter if you work at least:

• 500 hours in the current and prior Contribution Quarters combined, or
• 750 hours in the current and prior two Contribution Quarters combined, or
• 1000 hours in the current and prior three Contribution Quarters

Example

If you do not work at least 250 hours during a Contribution Quarter, and you do not meet the 500,750-, or 1000-hour requirements as described above, you are eligible to Self-Pay for the number of hours (up to 250) that you are short and maintain eligibility for the Corresponding Benefits Quarter.

We now accept credit card payments over the phone or in-person for Self-Pay and COBRA payments. Please call us at (630) 516-8008 to make a payment to maintain your eligibility for health benefits from the Welfare Fund.

Effective May 1, 2022, Cologuard is a covered benefit for routine screening for ages 45+.  A Cologuard test will be covered once every three years. Also, there is no longer a limiting top age for routine screening (it used to be age 75).

Effective May 1, 2022, colonoscopies for routine screening are covered at age 45+. Colonoscopies for people under age 45 will be covered if there is a demonstrated medical necessity. Also, there is no longer a limiting top age for routine screening (it used to be age 75).

The Plan includes short-term disability protection for you by providing income when you become disabled and cannot work because of a non-work-related disability.

You are eligible for weekly disability benefits if:
• You are a bargaining unit employee covered by this Plan;
• The disability begins while you are covered under this Plan;
• You are continuously disabled due to a non-work-related Injury or illness;
• You are unable to perform any job for wage or profit; and
• You are under the care of a Physician.
• Your disability is not due to any occupation or employment for remuneration, wage, or profit or for which
you are or may be entitled to benefits under any Workers’ Compensation, occupational disease, employer’s liability, or similar law; and
• You are not receiving any unemployment compensation.

The date benefits begin depends on the cause of the disability:
• If the disability is due to an Injury, benefits begin on the first day of disability.
• If the disability is due to an illness, benefits begin on the eighth consecutive day of continuous disability.

The amount of the weekly disability benefit is:

• $600 a week for up to the first 26 weeks of a disability; and
• $400 a week for up to the next 26 weeks of disability.

The maximum weekly disability payment period is 52 weeks per disability or until you recover, if sooner. Separate periods of disability are considered one period of disability unless the second disability is caused by an illness or Injury totally unrelated to the first disability and you have met the active work requirements.

Your weekly disability benefits will end on the earliest of the date:

• You are no longer under the care of a physician for the disability; or
• You recover from your disability; or
• You retire; or
• You die; or
• You receive all disability payments for that period of disability; or

You receive 52 weeks of short-term disability payments.

Participants and dependents are not eligible for weekly disability benefits.

A Health Spending Account (HSA), sometimes referred to as a “Flex Account”, is available to you and your covered dependents. This benefit helps to pay for health care expenses that are not covered by the Welfare Plan. The maximum benefit is $2,500 per family each calendar year.

To be reimbursed for expenses you must file a claim with the Fund Office, no later than April 1^st of the year following the expense.  Any amount left in the HSA account at the end of the year will revert back to the Plan.

In general, the HSA covers health care expenses that are not covered by the Welfare Plan, or that are in excess of the amounts the Plan pays.  To be eligible, expenses must be incurred while you are covered under the Welfare Plan.

Examples of the types of things that are covered under the HSA include, but are not limited to:

• Vision Care (Glasses, Contact Lenses)
• Prescription Drug Copayments
• Hearing Aides and Exams
• Orthodontic Treatment (for covered adults over age 19)
• Orthopedic Shoes
• Naprapath Services

The deadline for filing Health Spending Account (“Flex Account”) claims for the previous year is April 1^st. We encourage you to submit these claims, with all receipts and completed claim forms, throughout the year. (2022 Flexible Spending claims are due no later than April 1, 2023.)

The Board of Trustees of the Health and Welfare Fund made LASIK Eye surgery available to all covered participants and eligible dependents as of June 1, 2020.  The Fund will cover LASIK Eye surgery, including Photo Refractive Keratectomy (PRK) surgeries, 100% up to a lifetime maximum of $4,500 per eligible covered participant.

The Welfare Plan provides certain death benefits – employee, spouse, and child – to help protect your family against the effects of a sudden loss of income due to a death in the family.

Employee Death Benefit

The amount of benefit payable depends on the employee’s years of service under this Plan at the time of death.  If the employee has less than three years of service, the death benefit is $15,000.  If the employee has three or more years of service, the death benefit is $30,000.

Spouse’s Death Benefit

If the covered spouse of an eligible employee dies, there is a $12,500 death benefit available to help with funeral and final expenses. This benefit will be paid to the employee or, if both the employee and spouse die at the same time, to the employee’s estate. The IRS treats this benefit as taxable income.

To be eligible for this benefit, you and your spouse must be eligible for Plan benefits at the time of your spouse’s death and not on COBRA or in Plan C, and you must have been married to your spouse for at least one year.

Child’s Death Benefit

If your covered child, under age 22, dies, a $12,500 death benefit is available to help with funeral and final expenses. This benefit will be paid to the employee or, if both the employee and child die at the same time, to the employee’s estate.  The IRS treats this benefit as taxable income.

To be eligible for this benefit, you and your child must be eligible for Plan benefits at the time of your child’s death, and not on COBRA or in Plan C.

In the event of your death, the benefit amount is paid to your beneficiary. When you join the Plan, you complete a beneficiary designation form to name a beneficiary, who can be anyone you choose.

You can change your beneficiary at any time by completing and signing a new beneficiary designation form and submitting it to the Fund Office.  You may name more than one beneficiary. If any of your designated beneficiaries dies before you do, your death benefit would be paid in equal shares to any remaining beneficiaries who survive you, unless you indicated otherwise

on the form.

If you don’t name a beneficiary, or no named beneficiary survives you, your benefit is paid to:

• Your spouse; or if none, then
• Your child(ren) in equal shares; or if none, then
• Your parents in equal shares; or if none, then
• Your siblings in equal shares; or if none, then
• Your estate.

You are the beneficiary for the spouse’s death and child’s death benefit.

COBRA and Plan C employees and their dependents are not eligible for death benefits.