Health & Welfare
-- FAQ --

Who will receive my Life Insurance benefit in the event of my death?
The beneficiary named by you on the Welfare Plan records. It is important for you to keep your records up to date with the Welfare Plan Office.


When are my dependents covered?
If you have eligible dependents, their coverage is in force whenever your coverage is in force.


Does this Plan cover me if I am injured on the job?
No. However, Life and Accidental Death and Dismemberment benefits are payable for deaths.


How are Hospital benefits paid under the Comprehensive Medical Expense Benefit?
It is customary for benefits to be paid to you. However, if you assign the benefits to a Hospital, the Hospital will be paid directly.


Are x-rays in a clinic or Doctor's office covered?
X-rays in a clinic or Doctor's office are covered.


What is the maximum number of weeks I can receive the Disability Benefits before returning to work?
Thirteen weeks.


Must I sign the line marked "Assignment" on the Hospital and surgical forms?
No. Sign that line only if you want payment made directly to the Hospital or the provider of medical services.


What Hospitals are recognized and eligible for coverage by our Plan?
Those Hospitals which meet the definition of a Hospital on page 24 of this booklet are recognized by the Plan


Should I report an on-the-job iniury to the Welfare Plan Office?
Yes, you should report on-the-job injuries because you may be eligible for an extension of benefits during disability as described on page 32.


Should I report my induction into the Armed Forces?
Yes. Please refer to the section entitled, "Uniformed Services Employment and Reemployment Rights" on page 20 to find out the details.


If I am paid benefits that are greater than those to which I am entitled, what should I do?
If you are paid benefits either for medical or disability coverage to which you are not entitled, you should return the check to the Welfare Plan Office for correction. If you do not return the check, the amount of the overpayment will be deducted from future benefits to which you may be entitled.


What information should I furnish to the Welfare Plan Office for their permanent records?
The Welfare Plan Office must maintain a record of your name, Social Security number, your current home address, your current beneficiary, your birth date and whether or not you have eligible dependents. In the event of a change in any of these, the Welfare Plan Office should be notified promptly.


How can I find out that my employer is contributing to the Welfare Plan to maintain my eligibility?
The Welfare Plan Office furnishes quarterly status reports reflecting hours worked during the previous three calendar months. You should report to your Union and Welfare Plan Office any employer who is not contributing to the Fund. You must keep these for your records. Duplicates are notavailable.


If I have a claim, where should I send the forms and bills?
All forms, statements and bills should be sent directly to the address on the claim form.

If I need duplicate copies of claim forms or itemized bills which I submitted through the Welfare Plan Office, will they be furnished to me?
No.


How do I get a list of the Hospitals and Doctors in the Preferred Provider Network under the Comprehensive Medical Expense Benefit?
You may call the Plan Office toll-free at 1-800-621-4658 and request a listing of providers.


Why are the ACCESS POS and Welborn HMO Plans being offered?
To improve the medical coverage you receive at a cost the Plan can afford.


If I live in the service area, choose a point-of-service plan or HMO and use the participating providers, what will the Plan pay?
See the schedule of benefits or description of the benefits for the applicable POS/HMO program.


What if I choose a point-of-service Plan but use out-of-network providers?
The program generally pays for out-of-network providers at a lower rate. In some instances the rate could be lower than the Comprehensive Medical Expense Benefit.


If I choose the HMO Plan, what will the Plan pay?
See the schedule of benefits. There is no reimbursement for medical services performed by an out-of-network provider.