How much  is covered

Participating facility
Not-participating facility
Rules
 
 
 
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  UFCW LOCAL 1776 and PARTICIPATING EMPLOYERS
                                   HEALTH and WELFARE FUND
 
The Physical Well-Being Program is part of the Fund's effort to improve your general health. The benefits described below are designed to reduce your risk of medical problems by assisting you to stop smoking or lose excess weight, and enabling you to improve your cardiovascular health through exercise. Both you and your dependents eligible for benefits under the Physical Well-Being program. If you and your dependents are covered for physical well-being benefits under any other plan, please check the section titled "Coordination of Benefits" to see how to submit your claims.

What is Covered

The Physical Well-Being Program provides an allowance for membership in the following programs:

  Fitness Centers
Covered: membership fees, charges for classes
Not Covered: equipment, apparel, individual instruction

  Smoke Cessation Programs
Covered: fees, instruction, annual charges
Not Covered: equipment, medication, vitamins

  Weight Loss Programs
Covered: membership fees, meeting charges, manuals
Not Covered: food supplements, vitamins, medication

  Golf Club Memberships
Covered: membership fees
Not Covered: greens fees, apparel, cart rentals, equipment

  Swim Club Memberships
Covered: membership fees
Not Covered: daily usage fees, lessons, equipment

  Martial Arts Instruction
Covered: membership fees, lessons, instruction
Not Covered: equipment, apparel, instructional aids

How Much is Covered

The maximum amount of your benefit depends on whether you join a facility that is under contract with the Fund (participating) or a facility that is not under contract with the Fund (non-participating). If you purchase a  single membership  for yourself or for a dependent at a facility that participates in the Physical Well-Being Program through the Fund, you will receive a maximum allowance of $300 per calendar year. If you purchase a family at a participating facility, you will receive a maximum allowance of $500 per calendar year. If you purchase membership at a non-participating facility or program, you will receive a maximum reimbursement of $250 per calendar year. This $250 maximum applies whether you purchase a single or family membership.

Using the Physical Well-Being Program

Participating facility
If you wish to join a participating facility, simply notify the facility that you are a participant of the UFCW Local 1776 and Participating Employers Health and Welfare Fund. You will be given an eligibility form which both you and the center will complete. The participating center will then verify your eligibility with the Fund office. Once your eligibility is verified, you will be able to use that facility on a regular basis. If the participating facility requires that you make additional payments, you will be made aware of the specific amount and conditions of any additional co-payments at the time you join the facility.

Non-participating facility

If you join a non-participating facility, call the Fund office to request a reimbursement form. In order to receive reimbursement, you must submit the following items to the Fund office for verification:

  copy of agreement (contract) between you and the facility
  copy of itemized receipt and proof of payment
  completed reimbursement form indicating usage

If you sign up for an annual membership, both you and the facility must complete the reimbursement form and submit these items twice each calendar year (June 30 and December 31).If you join a program that is not utilized throughout the entire year (e.g. smoke cessation, weight loss, swim clubs, etc.), the reimbursement form and other information may be submitted when the program is completed rather than each June and December. Call the Fund office to request a reimbursement form approximately three weeks before the end of the calendar semester or the completion of the program.
Rules

Whether you use a participating facility or a non-participating facility, the Physical Well-Being Program is contingent upon the following terms:

  You must remain continuously employed/eligible throughout the duration of your membership or participation in a program.

  You must satisfy the following usage requirements for fitness centers:

Participating Facility - at least 10 usages per calendar quarter (Jan 1 - Mar 31, Apr 1 - Jun 30, Jul 1 - Sep 30, Oct 1 - Dec 31) with single memberships, or at least 17 usages per calendar quarter with family memberships.

Non-Participating Facility - at least 20 usages in each calendar semester (Jan 1 -  Jun 30, Jul 1 - Dec 31)

All claims for reimbursement must be submitted within 90 days of the end of the calendar year in which your membership or participation in a program occurred. Claims submitted after this period will not be reimbursed.