The following information together with the information contained in the Plan Description is being provided to you in accordance with government regulations
NAME OF PLAN/FUND
UFCW Local 1459 and Contributing Employers Health and Welfare Fund
ADDRESS OF PLAN/FUND OFFICE
Board of Trustees
UFCW Local 1459 and Contributing Employers Health and Welfare Fund
33 Eastland Street Springfield, MA 01109-2348
(413) 733-0177 Toll Free 1-800-634-2700
EMPLOYER IDENTIFICATION NUMBER /PLAN NUMBER
The Employer Identification Number (EIN) assigned by the Internal Revenue Service to the Board of Trustees, as Plan Sponsor is 22-2507311/501
FISCAL YEAR OF THE PLAN
All financial records of the Fund are kept on a fiscal year of November 1 to October 31
PLAN/FUND SPONSOR
This Fund and its Benefit Plans are maintained pursuant to the Collective Bargaining Agreements between United Food and Commercial Workers Union Local 1459 and those Employers who become parties to a Collective Bargaining Agreement. A copy of any such Agreement may be obtained by Participants and beneficiaries upon written request to the Trustees and is available for examination by Participants and beneficiaries at the Fund Manager's office. Participants and beneficiaries may receive from the Trustees, upon written request, information as to whether a particular employer or employee organization is a sponsor of the Plan.
TYPE OF ADMINISTRATION OF THE PLAN
The Plan/Fund is collectively bargained and is administered and maintained by a joint Board of Trustees, currently consisting of two Union Trustees and two Employer Trustees. The Board of Trustees is governed by the Trust Agreement established and maintained in accordance with Collective Bargaining Agreements.
The Stop & Shop Supermarket Company 136 South Main St
The Stop & Shop Supermarket Company 1385 Hancock Street
Quincy, MA 02169
The Board of Trustees is considered the “Plan Administrator.” The Trustees have complete discretionary authority to determine eligibility for benefits under the Benefit Plan or to construe and interpret the terms of the Benefit Plan, including ambiguous terms and meanings, and any other instruments or policies of the Fund. The duties and responsibilities of the Board of Trustees may be delegated to the Fund Manager.
PLAN/FUND ADMINISTRATION
The Fund is administered by the Board of Trustees. The Board of Trustees employs Zenith Administrators, Inc. as a Third Party Administrator to perform the routine administration of the Fund:
UFCW Local 1459 and Contributing Employers Health and Welfare Fund
33 Eastland Street Springfield, MA 01109-2348 Service of legal process may also be made on any Trustee.
LEGAL COUNSEL
Mr. Joseph Semo, Esq.
Semo Law Group
1800 M Street. NW, Suite 730 S Washington, DC 20036
NAME AND ADDRESS OF THE INSURANCE COMPANY
The Life Insurance and AD&D programs are insured by The Union Labor Life Insurance Company;
The Union Labor Life Insurance Company Group Life Claim Department
8403 Colesville Road Silver Spring, MD 20910
202-682-0900
TYPE OF PLAN
This Plan is a welfare plan that provides Life Insurance, Accidental Death & Dismemberment, Weekly Disability Income, Medical, Dental, Prescription Drug, and Vision Benefits to eligible employees and their dependents (where specifically indicated).
FUNDING MEDIUM/SOURCE OF CONTRIBUTION OF THE BENEFITS FUND
The Plan is funded through contributions to the Fund by contributing employers at rates established by and in accordance with the Collective Bargaining Agreements between the Union and participating employers, and by investment income earned on a portion of the Fund’s assets. Contributions may also be required by employees pursuant to the collective bargaining agreement and/or participation agreement relating to their participation. Contributions are held in a Trust Fund for the purpose of providing benefits to covered Participants and defraying reasonable administrative expenses. Under certain circumstances, Participants and beneficiaries losing eligibility under the Plan may maintain eligibility for a limited period of time on a self-pay basis.
The assets and reserves of the trust are held in trust by the Trustees in a trust fund pursuant to an Agreement and Declaration of Trust.
ELIGIBILITY
The Plan’s requirements with respect to eligibility for Participants and for beneficiaries, as well as circumstances that may result in disqualification, ineligibility, or denial, loss, forfeiture, or suspension of any benefits are described in this Plan Description, starting on page 2. Also, please note any restrictions or requirements of particular benefits are set forth in the sections of this document which describe those benefits.
DESCRIPTION OF BENEFITS
The benefits provided by this Fund are set forth in the various Plan Descriptions. The complete terms of any insured benefits provided through an insurance company engaged by the Fund are provided in a certificate of coverage. This certificate, if applicable, is available to Participants and beneficiaries from the Fund Manager's office upon request.
TERMINATION PROVISIONS
The UFCW Local 1459 and Contributing Employers Health and Welfare Fund shall continue during the term of the collective bargaining agreements referred to herein and during the term of any renewal or extension of the agreements. In the event that the obligations of all the participating employers to make contributions and negotiations terminate, the Trustees will determine how any assets, which may remain after expenses have been paid, will be disposed.
Any distribution made by the Trustees shall be made only for the benefit of former eligible Participants and for legitimate Fund purposes.
CLAIMS PROCEDURE
The procedure for filing a claim for benefits is set forth in the document. If all or any part of your claim is denied you may appeal that decision. A Participant or Eligible Dependent must submit the claim within 15 months of the date on which the services were rendered.