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UFCW LOCAL 1776 and PARTICIPATING EMPLOYERS                                   HEALTH and WELFARE FUND

 

Life Insurance Benefits

Fund also provides you with life insurance benefits under a policy of insurance with Standard Insurance Company (“Standard”). Your dependents are not covered. The amount of your coverage is $3,000.

If you die from any cause, the amount specified on the chart will be paid to your beneficiary or beneficiaries. You can name one or more beneficiaries and can change beneficiaries at any time. If you do not name a beneficiary, your life insurance is paid in the following order:    Spouse    Children    Parents    Siblings    Estate If You Are Disabled If you are unable to work because of a disability, your coverage under the Fund continues while you are disabled for up to six (6) calendar months beginning with the first month following your last day of work. If you are still not working at the end of the six-month period and are still disabled, your life insurance benefit will terminate. You may, however, be eligible to continue your life insurance under the group policy without payment of premiums if you are totally disabled (called “waiver of premium benefit"). For this purpose, “totally disabled” means that as result of sickness, accidental injury or pregnancy you are unable to perform the material duties of any occupation for which you are reasonably suited by education, training and experience. You should contact the Fund office immediately for more details if you think that you may be eligible for a waiver of premium benefit. Alternatively, you may apply for conversion coverage upon termination of your life insurance coverage, as described below. The amount of your life insurance benefit will be reduced by the amount of death benefits, if any, payable by the Tri-State Pension Fund. Converting Coverage If you leave the bargaining unit, stop working for a participating employer or retire, your life insurance coverage ends. You can, however, submit an application to convert to an individual life insurance policy. You pay the premium for this coverage, which is based on your age at the time your life insurance under the Fund ends. To qualify, you must apply to Standard and pay your premium within 31 days of the date your coverage ends. You will not have to submit evidence of insurability. If you die during the 31-day conversion period, the death benefit will be payable under the group life insurance policy, whether or not you have applied for an individual policy. Notice of right to convert You will receive a written notice of your right to convert to an individual life insurance policy no later than 15 days before the end of the 31-day conversion period. If you do not receive notice, your right to convert will be extended until: a) 15 days after notice is given, or (b) 60 days after the end of the initial 31 day conversion period, whichever is earlier. However, insurance under the group life insurance policy will never continue beyond the initial 31-day conversion period. Please note: This life insurance benefit is provided pursuant to a policy of insurance. That policy of insurance is incorporated by reference as if fully set forth herein. If there are any differences between the benefit description set forth in this booklet and the policy of insurance, the policy of insurance prevails. If you wish to review the policy of insurance, please contact the Fund office.