UFCW LOCAL 1776 and
PARTICIPATING EMPLOYERS
HEALTH and WELFARE FUND
Coordinating With Medicare
If you are covered by Medicare and you are not retired, this Plan is the primary
plan and Medicare is the secondary plan. If you are over age 65 and elect to continue coverage under this plan,
your benefits remain the same as the benefits of active participants who are
under age 65, as described in this booklet.
If you are no longer employed by a contributing employer, and you are
entitled to Medicare on the basis of disability, Medicare is the primary plan,
except if the disability is based upon end-stage renal disease.
If the disability is based upon end-stage
renal disease, the Fund will be primary for 30 months, beginning with the first
month in which you receive kidney
dialysis and ending on the earlier of the 30th month thereafter or the date you
receive a kidney transplant.
The Fund has the right of subrogation or full reimbursement for all costs and
benefits paid or incurred, or which will be incurred in the future, when any
claim for benefits is filed on your behalf where the event(s) that caused the
claim are or may be the fault of, or the claim may be payable by, any other
party, including but not limited to Workers’ Compensation, an insurance policy,
another benefit plan, or any party that may be responsible for the event(s)
related to the claim. In these cases,
you must notify the Fund of the existence of any such party and/or the
occurrence of any such event(s).
You are also obligated to notify the Fund if you receive payment from any party. If
you are involved in a
lawsuit, insurance claim, other claim or settlement as a result of such events,
you must notify the Fund of the name and address of any counsel you retain,
insurance adjuster handling the claim, the progress of the case or claim, any
settlement offers, trial dates, payments, etc.
The Fund is entitled to 100% reimbursement of all costs and benefits,
except as may be specifically agreed to by the Fund in writing, when you
receive any payment from another party, if the Fund has paid or incurred, or
will incur in the future, any such costs and/or benefits.
The Fund’s rights of subrogation and
reimbursement shall be honored regardless of whether the participant or
beneficiary has been, or will be, made whole.
So if you submit a claim and receive payment from another party for the
same claim or as a result of the injury or illness, you must reimburse the
Fund.
