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What happens to my participation if I leave the industry and then come back?
In most situations, you will need to meet the Welfare Fund’s initial eligibility rules again. If you worked fewer than 215 hours in an employment quarter, coverage for you and your eligible dependents will begin again on the first day of the third month after the employment quarter in which you work 215 or more hours for a contributing employer.
What happens to my coverage when I retire?
If you retire between the ages of 62 and 65 and are receiving a Regular, Reduced, or Service Pension from the Teamsters Local 814 Pension Fund, you may continue medical and prescription drug for yourself and your eligible dependents by self-paying for coverage until you reach age 65 and become eligible for Medicare. If your spouse turns age 65 before you, your spouse’s coverage will end at that time. We will reimburse $125.00 for single coverage and $250.00 for family coverage each month with proof of purchase of a health plan.
What happens to my spouse’s coverage if I get divorced?
Your spouse’s participation ends as of the date your divorce is final. Continued coverage under COBRA may be available.
My dependent information will not fit on the enrollment form. What should I do?
If you do not have enough room on the enrollment form to list your dependent information, provide all the required information on a separate sheet of paper and attach it to your Enrollment Form.
My child doesn't’t have a Social Security number. Does that mean my form will be considered incomplete?
No. To ensure access to all future benefits, provide the Fund Office with your child’s Social Security numbers as soon as the number is available.
How do I find providers that participate in the medical network?
Visit CIGNA's Web site.
I lost my ID card. How do I get a new one?
Contact the Fund Office.
How do I find providers who participate in the dental network?
Call DDS Inc. at 1-800-255-5681 or visit the DDS Inc. Web site. Our group number is 814.
Does the Welfare Fund cover prescription contacts?
Yes. The Fund also covers vision exams and glasses and frames.
Can I get disability benefits if I’am getting a Disability Pension?
No. If you are receiving benefits or are eligible for a monthly pension from the Pension Fund, you’re not eligible for disability benefits from the Welfare Fund.
What happens if I don’t name a beneficiary for my life insurance?
If you do not have a beneficiary listed, benefits will be paid to:
The Teamsters Local 814 Welfare Fund is designed to help members and their eligible dependents afford proper health care. The Fund also provides members with disability, life and accident insurance coverage.
When Participation Begins |
You’re eligible on the first day of the third month following the employment quarter in which you worked at least 215 hours as an industry or seniority employee or 300 hours as an apprentice employee of covered work with contributing employers . Employment quarters are August to October, November to January, February to April, and May to July. Your Plan participation generally starts automatically on the day you become eligible. |
Medical (for you and your eligible dependents) |
The Fund helps you and your family get and stay well. When you use Aetna Open Access Managed Choice POS providers, your out-of-pocket costs are less than if you use out-of-network providers. |
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AETNA generally pays 100% of the allowed amount , after a $25-per-visit co payment, and after a $100 individual or $200 family annual deductible. The Fund provides unlimited lifetime benefits for in-network care.
Under AETNA there will be a $100 ER visit co-pay and a $100 in-patient admission co-pay. (ER co-pay waived if admitted)
Yearly out of pocket maximum is $1000 per individual & $2000 per family. |
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The FUND pays 70% of the allowed amount for hospital care and, after a $250 individual or $500 family annual deductible,70% of the allowed amount for most other eligible medical expenses (subject to Plan limits). |
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The Fund’s In-House Benefits include:
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Prescription Drug (for you and your eligible dependents) |
Effective January 1, 2006 your prescription drugs are provided through a new company, Prescription Solutions. The drugs covered did not change, but to fight the high cost of prescriptions and medical benefits in general, we have made some changes. The new plan rules work like this: if there is a brand and generic equivalent of the same drug, the Fund will pay the cost of the generic only. If you choose the brand anyway you are responsible for the difference in cost between the brand and generic equivalent. This could be a great deal of money. To save that cost please ask your doctor to prescribe generic drugs whenever possible.
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The new co-payments are $4 for a generic drug and in those cases where there is no generic drugs, only brand, the co-payment is $20. You can get a 30-day supply per prescription and 1 refill at the Pharmacy. You must show your ID card at the time you fill your prescription. For information about participating pharmacies, call Prescription Solutions @ 1-800-797-9791 or contact the Fund Office.
If you choose a brand name drug when a generic equivalent is available, you will also pay the difference in price.
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You must use this program for maintenance medication (that is, medication taken on a long-term basis for chronic conditions such as asthma or diabetes). The new co-payments for a 90 day supply are $8 for a generic drug and and $40 for a brand name drug when no generic equivalent is available. If you choose a brand name drug when a generic equivalent is available, you will also pay the difference in price |
Dental (for you and your eligible dependents) |
As of March 1,2007 there is an $25 annual deductible per family member.
The Fund provides up to $2,000 per person per year for diagnostic and preventive, basic and major services, and up to $1,200 per person per lifetime for orthodontia treatment.
When you use DDS Inc. network providers, your out-of-pocket costs are less than if you use out-of-network providers.
DDS Inc. 1-800-255-5681
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Vision (for you and your eligible dependents) |
You will get $25 for the optical exam and $75 for lenses and frames every year if you are in Plan I or every two years if you are in Plan II. You can use the $75 benefit toward the purchase of contact lenses. Please contact the Fund Office for an Optical voucher. |
Hearing (for you and your eligible dependents) |
Benefits are payable up to $1,000 if you are in Plan I or $250 if you are in Plan II per person every two years. Please contact the Fund Office for a Hearing Aid voucher. |
Short-Term Disability Benefits (for you only) |
You have a source of income if you’re unable to work due to a non-work-related accident or illness. The benefits payable by the Fund are at least equal to, but do not duplicate, benefits payable under any federal or state unemployment, disability, or cash sickness benefit or similar law. |
Life Insurance (for you only) |
Benefits are payable to your beneficiary if you die. The amount of coverage varies. Contact the Fund Office for more information. |
Accidental Death & Dismemberment Insurance (for you only) |
Benefits are payable to your beneficiary if you die, or to you if you are seriously injured. The amount of coverage varies. Contact the Fund Office for more information. |
Contributing employers pay the full cost of coverage and make all contributions. Employee contributions are not required or allowed. Employer contributions are based on the rate(s) specified in applicable collective bargaining agreements.
| Plan Name | Teamsters Local 814 Welfare Fund |
| Plan EIN | 11-623-435-9 |
| Plan Number | 501 |
| Plan Year | January 1 – December 31 |
| Type of Plan | Welfare benefits plan |
| Plan Administrator | Board of Trustees |
