Rights
Under The Employee Retirement Income Security Act (ERISA)
Participants in
the Carpenters Health and Security Plan of Western Washington – For
Retired Carpenters are entitled to certain rights and protections under the
Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all
plan participants are entitled to:
Receive
Information About The Plan And Plan Benefits
- Examine,
without charge, at the Trust Office and at other specified locations, such as
worksites and union halls, all plan documents governing the plan, including
insurance contracts and collective bargaining agreements, and a copy of the
latest annual report (Form 5500 Series) filed by the plan with the U.S.
Department of Labor and available at the Public Disclosure Room of the Pension
and Welfare Benefits Administration.
- Obtain,
upon written request to the plan administrator, copies of documents governing
the operation of the plan, including insurance contracts and collective
bargaining agreements, and copies of the latest annual report (Form 5500 Series)
and an updated summary plan description. The plan administrator may make a
reasonable charge for the copies.
- Receive
a summary of the plan’s annual financial report. The plan administrator is
required by law to furnish each participant with a copy of this summary annual
report.
Continue
Group Health Plan Coverage
- Continue
health care coverage for a spouse or dependent children if there is a loss of
coverage under the plan as a result of a qualifying event. A spouse or dependent
children may have to pay for such coverage. Review this plan booklet and the
documents governing the plan on the rules governing COBRA Continuation Coverage
rights.
- Reduction
or elimination of exclusionary periods of coverage for preexisting conditions
under the group health plan, if there is creditable coverage from another plan.
A certificate of creditable coverage is provided, free of charge, from a group
health plan or health insurance issuer when coverage is lost under the plan,
when an individual becomes entitled to elect COBRA Continuation Coverage, when
COBRA Continuation Coverage ceases, if a certificate is requested before losing
coverage, or if it is requested up to 24 months after losing coverage. Without
evidence of creditable coverage, an individual may be subject to a preexisting
condition exclusion for 12 months (18 months for late enrollees) after the
enrollment date in the coverage.
Prudent
Actions By Plan Fiduciaries
In addition to
creating rights for plan participants, ERISA imposes duties upon the people who
are responsible for the operation of the plan. These people who operate the
plan, called “fiduciaries” of the plan, have a duty to do so
prudently and in the interest of all participants and beneficiaries. No one,
including the participant’s employer, union or any other person, may fire
the participant or otherwise discriminate against him or her in any way to
prevent the participant from obtaining a benefit or exercising his or her rights
under ERISA.
ERISA
Rights
If a claim for a
benefit is denied or ignored, in whole or in part, the participant has a right
to know why this was done, to obtain copies of documents relating to the
decision without charge, and to appeal any denial, all within certain time
schedules. Under ERISA,
there are steps that can be taken to enforce the above rights. For
instance:
- If
the participant requests materials from the plan and does not receive them
within 30 days, he or she may file suit in a federal court. In such a case, the
court may require the plan administrator to provide the materials and pay up to
$110 a day until the participant receives the materials, unless the materials
were not sent because of reasons beyond the control of the plan
administrator.
- If
the participant has a claim for benefits which is denied or ignored, in whole or
in part, he or she may request a hearing and appeal to arbitration. In the
alternative, a suit may be filed, but the court may dismiss the action in favor
of the Trust’s hearing and arbitration procedures.
- If
it should happen that plan fiduciaries misuse the plan’s money, or if the
participant is discriminated against for asserting his or her rights, he or she
may seek assistance from the U.S. Department of Labor, or he or she may file
suit in a federal court. The court will decide who should pay court costs and
legal fees. If the participant is successful, the court may order the person
sued to pay these costs and fees. If the participant loses, the court may order
him or her to pay these costs and fees, for example, if it finds the claim is
frivolous.
If
there are questions about the plan, contact the plan administrator. If there are
questions about this statement or about rights under ERISA, contact the
Department of Labor at one of the following addresses, for assistance and
information: Pension
and Welfare Benefits
Administration, U.S.
Department of
Labor, Seattle District
Office 1111 Third
Avenue, Suite 860 MIDCOM
Tower Seattle, WA
98101-3212 Phone (206)
553-4244;
or Division
of Technical Assistance and
Inquiries, Pension and
Welfare Benefits
Administration U.S.
Department of Labor 200
Constitution Avenue,
N.W. Washington, D.C.
20210
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