LOCAL 183 MEMBERS' BENEFIT FUND

HOW THE TRUST FUND WORKS

The benefits provided by the Trust Fund are purchased from insurance companies with contributions made by your employer on your behalf. These contributions are made to the Trust Fund as a result of a Collective Bargaining Agreement.
The Trustees are responsible for the design of the benefit package provided by the Trust Fund and for the allocation of the contributions made to the Trust Fund. To help carry out their duties, the Trustees have appointed various people such as accountants, consultants, and lawyers to provide them with professional advice. The Trustees meet with these advisors from time to time to review matters that arise in the running of the Trust Fund. The Trustees make all decisions that are necessary at these meetings by taking a vote amongst themselves. The plan’s Administrative Agent performs the daily administrative functions of the Trust Fund.
It is hoped that the Trust Fund will be continued indefinitely, but as is customary in group insurance plans, the right of change or discontinuance at any time must be reserved. Please note that any benefit that is provided at a particular time cannot be guaranteed for any specific period of time, unless required by legislation. The Trustees reserve the right to amend, suspend, delete or terminate any benefit at any time as in their discretion they deem appropriate.
The Trustees have the power to disentitle any person to past, present or future benefits and to take any further action they deem appropriate, including denying membership in a Plan, to any person where the member or persons claiming through the member are found by the Trustees to be abusing the Plan or making false or improper claims under the Plan.

WHAT IS IT FOR YOU?

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It is absolutely essential that you complete an Application Card, which you can obtain from your Administrative Agent or here. On this card, you name the beneficiary/beneficiaries, to whom your Life Insurance should be paid, in the event of your death. Members should list all dependants that are eligible for insurance.

If you have already completed an Application Card and you have no desire to change your beneficiary/beneficiaries, it is not necessary for you to complete another card. You may change your named beneficiary/beneficiaries, subject to Provincial Law, by written request, filed with the Administrative Agent. The change will take effect as of the date such request was executed, but without prejudice to the Plan for any payment(s) made before such request is received by the Administrative Agent.

Please be sure to fully complete and sign the Application Card, and return it to the Administrative Agent. It is extremely important that a completed Application Card be on file, since claims cannot be paid on behalf of you, or your eligible dependants.

After your insurance becomes effective, it is necessary for you to notify the Administrative Agent of any change in your dependant or marital status. This information is necessary so that your coverage can be adjusted accordingly.

Any personal information collected by the Trustees and the Administrative Agent is used only to the extent required by law. To authorize an individual to have access to your personal information, you must complete an Authorization to Release Personal Information Form and return it to the Administrative Agent. Only authorized persons have access to your personal information when required for coverage purposes.

This Plan is for Members:

• Members who are covered under a Provincial Health Insurance Plan.
• Members in Good Standing with LiUNA Local 183.
• Members of a Bargaining Unit represented by LiUNA Local 183.
• Members who work for a Contributing Employer and where the Collective Agreement makes provisions for contributions to the Local 183 Members Benefit Fund.

You will become eligible for benefits provided by the Plan as follows:

• On the 1st day of the 2nd month following the date you have accumulated two months of the monthly requirement (260 hours) made by your employer on your behalf as outlined by the Board of Trustees.
• Coverage continues automatically for each month provided you have the required minimum of 130 hours in your Hour Bank Account. The Administrative Agent will deduct the monthly requirement of 130 hours from your Hour Bank Account monthly.

The Administrative Agent keeps an account of the hourly contributions made by your employer on your behalf. Hours are stored (banked) for future use when more than the 130 hour monthly requirement are worked and submitted by your employer for your monthly benefit coverage.

The maximum number of hours you can accumulate in your Hour Bank Account is 3,120 hours. This number represents a maximum of 24 consecutive months of coverage.

If you earn in excess of 3,120 hours in your Hour Bank Account, the excess is transferred to the general reserve of the Members Benefit Fund.

Coverage for you and your dependents will terminate on the earliest of, the date:

• On the last day of the month that you have less than the monthly 130 hour requirement or you do not make the necessary self-payment to maintain your coverage.
• On the last day of the month you stop making self-payments or are not permitted to make future self-payments.
• You cease to be a member in Good Standing of LiUNA Local 183.
• Upon your attainment of age 65 with respect to Long Term Disability Benefits; age 70 for Short Term Disability Benefits, Accidental Death & Dismemberment, Occupational Accidental Death & Dismemberment, Hospital Cash, Critical Illness, Special Medical/Hospital Coverage while in Canada and Permanent Total Disability Accident Benefits; age 75 for Life Insurance, Dependent Life Insurance and Special Needs Life Insurance; and age 80 for Emergency Out of Province coverage.
• Coverage for your dependents will terminate on the date such dependents cease to be eligible.
• When your coverage terminates, you may have a small balance in your Hour Bank Account (less than 130 hours) which will be cancelled if hours are not received by the Administrative Agent within 12 months of the date of termination.
• You enter Military Service.
• This Plan is discontinued.

Should your coverage terminate because you are unemployed and have recall rights you will be given the option to continue your coverage by making self-payments to the Members Benefit Fund on the following basis:

• Monthly payments in the amount of $95.00 plus 8% Retail Sales Tax for a total of $102.60 per month.
• You have the option to make self-payments for a maximum of 12 consecutive months provided you remain a Member in Good Standing with LiUNA Local 183.
• You are entitled to the same benefits you enjoyed while you were employed with the exception of Short Term Disability, Long Term Disability and Long Term Care Benefits.
• Self-payments must be made within 31 days of the termination of your coverage and must be made on a continuous basis. Retroactive self-payments will not be accepted.
• Your Union Dues with LiUNA Local 183 must be maintained and in a current status.
• The Trustees may adjust the self-payment amount from time to time.

The cheque should be made payable to “Local 183 Members Benefit Fund” and mailed to:
Local 183 Trust Administration
205 - 1263 Wilson Avenue
Toronto, ON M3M 3G2

You should be sure to print your name and Union ID Number on the back of your cheque to ensure that your account is properly credited.

If you choose to pay directly, as provided for above, it is your responsibility to contact the Administrative Agent and make the necessary payments by the 15th of each month. Coverage is terminated if you fail to make the necessary payments on time.

If you were previously covered by the Plan and have been terminated and subsequently return to work in which a Collective Agreement requires your employer to contribute to the Members Benefit Fund, you will be covered by the Plan:

• On the first day of the second month following the date you have accumulated 130 hours of the required monthly deduction in your Hour Bank Account, or

If you are out-of-benefit for a period greater than 12 consecutive months, you will be treated as a new member and you will be covered by the Plan:

• On the first day of the second month following the date you have accumulated 260 hours of the required deduction in your Hour Bank Account.

Extended Health Care and Dental Care Benefits will continue beyond the date of your death while payments for such coverage are made by the Trust Fund on behalf of your eligible dependents, provided you were eligible for benefits at the date of death, but not beyond the earliest of:

• The date such dependents cease to be eligible.
• The date your surviving spouse remarries (children will continue to be covered).
• The date coverage for your dependents terminates as per the definition of dependent or for any other reason.
• The date your child attains the age of 21 or the age of 25 provided they are attending an accredited school, college, or university as a full time student.
• The date following the exhaustion of any balance in your Hour Bank Account at the date of your death, coverage will continue for surviving spouse to a maximum of 10 years or the attainment of age 55.
• Extension of coverage for surviving spouse to the attainment of age 55 should your death be as a result of an occupational accident. You will be required to provide annual proof to the Administrative Agent.

Extended Health Care and Dental Care Benefits will continue beyond the date an unmarried child attains the limiting age of 21 or 25 provided they are attending an accredited school, college or university as a full time student, provided proof is submitted to the Administrative Agent within 31 days after such date that such child:

• Is incapable of supporting themselves due to a physical or psychiatric disorder.
• Become so incapacitated prior to attainment of the limiting age.
• Is chiefly dependent upon you for support and maintenance.
• Thereafter such proof must be submitted to the Administrative Agent as required, but not more often than yearly.

If you are totally disabled on the date your insurance terminates, entitlement to Extended Health Care, Dental Care, Emergency Out of Province and Life Insurance benefits will be the same as though such insurance had not terminated provided you submit proof to the Administrative Agent for as long as you remain continuously disabled, and are currently in receipt of Short Term Disability, Long Term Disability, Workers Safety Insurance Board (WSIB) and / or Canada Pension Plan (CPP) Disability Benefits, as follows:

• Members on Short Term Disability will be required to remit a monthly payment of $95.00 plus 8% R.S.T, a total of $102.60 for continuous benefit coverage up to a maximum of twenty-four (24) months following the exhaustion of your Hour Bank Account provided you remain in receipt of Short Term Disability Benefits for disabilities on or after October 1, 2011;
• Members on Workers Safety Insurance Board (WSIB) Disability Benefits will be fund assisted for benefit coverage from the date of disability for a maximum of twelve (12) consecutive months provided you remain in receipt of WSIB benefits. Your Hour Bank Account is frozen during the twelve (12) month period. Following the twelve (12) month period and exhaustion of your Hour Bank Account, members are required to remit a monthly payment of $95.00 inclusive of 8% R.S.T. for benefit coverage listed above provided you remain in receipt of Worker Safety Insurance Board disability benefits. You have one (1) year from the date of the accident to report your WSIB claim to the Administrative Agent;
• Members on Long Term Disability will be required to remit a monthly payment of $95.00 inclusive of 8% R.S.T. for continuous benefit coverage provided you remain in receipt of benefits for disabilities on or after October 1, 2011;
• Members on Canada Pension Plan (CPP) Disability Benefits will have their benefit coverage on a complimentary basis for disabilities on or after October 1, 2011;
• Eligibility for benefits will be conditional on you remaining a Member in Good Standing with LiUNA Local 183 and you becoming disabled on or after October 1, 2011;
• You will be required to provide proof that you continue to be in receipt of the above benefits on an annual basis;
• Coverage will terminate on the date of your death, return to employment, recovery or the attainment of age 65 for all benefits.

You must complete a new Application Card to update your dependent or marital status. For example, if you were a single member when your insurance commenced and you get married at a later date, or you were married at the time insurance commenced and sometime later your family includes a child.

You must advise the Administrative Agent within 31 days of a change in your dependent status. Failure to do so could jeopardize the coverage of a newly acquired dependent.

This information is important to ensure uninterrupted coverage and avoidance of any delays in the assessment of claims.

Your dependents become eligible for coverage when you become eligible or, if acquired later, upon becoming your dependent provided they are covered under a Provincial Health Insurance Plan. If your spouse also has coverage through their employer, you must co-ordinate your benefits through this plan with your spouse’s plan. You must advise the Administrative Agent if you or your dependents are covered under another plan, such as your spouse’s benefit plan.

To be eligible for benefits, your eligible dependents include your spouse and dependent children as identified below.

SPOUSE

• Spouse means a husband or wife by virtue of a valid civil or religious ceremony.
• Common Law Spouse means a person living with the member for a minimum of 12 consecutive months and will be deemed to be the member’s spouse if such person is publicly represented as the member’s spouse.
• Same-sex spouses are eligible provided that the relationship includes continuous cohabitation of a minimum of 12 consecutive months and public representation of married status.
• Divorced spouses are not eligible for coverage.

DEPENDENT CHILDREN

• Dependent child means a natural or legally adopted child; or a stepchild or other child who is dependent upon the member for support and lives with the member in a regular parent/child relationship.
• Dependent children must be 20 years of age or younger (children from 21 years of age but under age 25 will be covered provided they are attending an accredited school, college or university as a full-time student. Annual proof of student registration (original) must be provided to the Administrative Agent).
• Dependent children must be dependent on you for support, unmarried and not employed at a regular full-time job.

If a member becomes disabled due to a work-related injury and are eligible for Workplace Safety and Insurance Board (WSIB) benefits, the member and eligible dependents will remain covered for the Plan’s benefits in which their hour bank will be frozen for a maximum period of 12 months from the date of disability while in receipt of WSIB benefits under the Workplace Safety and Insurance Act. Members must report their WSIB claim number and submit Proof of Acceptance of their claim by WSIB to the Administrative Agent as soon as possible. Members have one (1) year from the date of the accident to report their WSIB claim to the Administrative Agent and are to continue to remain a member in Good Standing with LiUNA Local 183.

If you are a Retiree covered under the Labourers’ Local 183 Retiree Benefit Trust Fund who is receiving a monthly pension from the LiUNA Labourers’ Pension Fund or the B.M.I.U.C. Local 1 Pension Fund and you return to work with a participating employer, your coverage under the Labourers’ Local 183 Retiree Benefit Plan will pause and you will begin to generate eligibility under LiUNA Local 183 Members Benefit Fund and will be classed as an Active Member. Once you accumulate enough hours in your Hour Bank Account under the LiUNA Local 183 Members Benefit Fund, you will be considered to be an Active Member under the LiUNA Local 183 Members Benefit Fund and not a Retiree. You cannot have active benefit coverage as an Active Member and a Retiree at the same time.

Coverage will terminate if a Retiree enters into an active working relationship with an entity contrary to the interests of LiUNA Local 183. Coverage under the Labourers’ Local 183 Retiree Benefit Trust Fund will reactivate once you are no longer employed/working in the industry and benefits exhaust under the LiUNA Local 183 Members Benefit Fund.

Under current tax law Life Insurance, Accidental Death and Dismemberment, Occupational Accidental Death and Dismemberment, Permanent Total Disability Accident, Long Term Care, Critical Illness, and Hospital Cash premiums paid to an insurance company are taxed as income to the member in the calendar year in which it was received. Members who were covered for these benefits in the previous calendar year will receive a T4A every February from the Administrative Agent that indicates the total amount of premium paid in the prior year.

Benefits received from the plan are not taxable with the exception of Short Term Disability, Long Term Disability, Bereavement Pay, Parental Leave, and Jury Duty Benefit payments which are also reported on the T4A form received from either the Administrative Agent or directly from the insurer.

Any premiums paid for the above referenced benefits on behalf of the member (shown on the T4A) must be reported by the member as income in the member’s annual income tax return.

The Ontario Health Plan (OHIP) pays most medical and surgical services required by residents of Ontario and their eligible dependents. It also pays for standard ward hospital charges. Regulations for the Ontario Health Plan are made under the Ontario Health Insurance Act and will change from time to time.

Should you have any questions relating to the commencement date or termination procedures of your OHIP coverage, you should contact OHIP directly.

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