Operating Engineers Health & Welfare Fund

General Information

[ Back]  [ Up

ERISA Plan Information

Board of Trustees

 

INFORMATION REQUIRED BY THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974

1.

Name of Plan.

This Plan is known as the Operating Engineers Health and Welfare Fund.

 

2.

Plan Administrator and Sponsor.

The Board of Trustees is the Plan Administrator.  This means that the Board of Trustees is responsible for seeing that information regarding the Plan is reported to government agencies and disclosed to Plan participants and beneficiaries in accordance with the requirements of the Employee Retirement Income Security Act of 1974.

The Fund Office will provide you, upon written request, information as to whether a particular employer is contributing to this Plan on behalf of participants in the Plan and, if the employer is a contributor, the address of the employer.

 

3.

Board of Trustees.

The Board of Trustees consists of an equal number employer and union representatives, selected by the employers and union, in accordance with the Trust Agreement which relates to this Plan.

If you wish to contact the Board of Trustees, you may use the address and phone number below:

 

Operating Engineers Health and Welfare Fund
100 E. Corson Street
Pasadena, California 91103
(626) 356-1000

 

The Trustees have designated the Administrative Organization named below to perform the routine functions of the Plan:

Operating Engineers Funds, Inc.
100 E. Corson Street
Pasadena, California 91103
(626) 356-1000

 

4.

Names, Titles and Addresses of Any Trustee or Trustees.

As of November 1, 2005, the Trustees of this Plan are:

  EMPLOYER TRUSTEES
 

William Schmidt
SCHMIDT CONSTRUCTION
7633 Loma Verde Ave.
Canoga Park, CA 91304

Alexander Rados
Steve P. Rados, Inc.
2002 E. McFadden Ave.
Santa Ana, CA 92705

C. W. Poss
C/O ECM
5267 Warner Ave., #124
Huntington Beach, CA 92649

Tim MacDonald
C. A. Rasmussen, Inc.
2360 Shasta Way
Simi Valley, CA 93065

Walt Elliot
3005 Ripon Drive
Las Vegas, NV 89134

Les Farrow
Les Farrow Excavating & Grading
17892 Jamestown Lane
Huntington Beach, CA 92647

John Nelson
FCI CONSTRUCTORS, INC.
2585 Business Park Dr.
Vista, CA 92081

Mitch White
MANSON CONSTRUCTION
1617 Pier "D" Street
Long Beach, CA 90802

  UNION TRUSTEES
 

William C. Waggoner
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103

Mickey J. Adams
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103

Kurt Glass
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103
John Spaulding
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103
Steve Billy
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103
Fred Young
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103
Robert W. Burns
I.U.O.E., Local #12
150 E. Corson Street
Pasadena, CA 91103

5.

Identification Numbers.

The number assigned to the Plan by the Internal Revenue Service is 95-6034886.  This Plan Number is 003.

 

6.

Agent for Service of Legal Process.

The name and address of the agent designated for the service of legal process is:

Michael P. Graydon

Operating Engineers Funds, Inc.

100 E. Corson Street

Pasadena, California 91103

Legal process may also be served on a Plan Trustee.

 

 

7.

Collective Bargaining Agreement.

Contributions to this Plan are made on behalf of each employee in accordance with Collective Bargaining Agreements between I.U.O.E., Local #12 and participating employers.

The Fund Office will provide you, upon written request, a copy of the Collective Bargaining Agreement.  The Collective Bargaining Agreement is also available for examination at the office of the Plan Administrator.

 

8.

Source Of Contributions.

The benefits described in this section are provided through employer contributions to this Plan.  The amount of employer contributions to this Plan is determined by the provisions of the Collective Bargaining Agreements with employer representatives.  The Collective Bargaining Agreements require contributions to this Plan at a fixed rate per hour worked.  The Fund Office will provide you, upon written request, information as to whether a particular employer is contributing to this Plan on behalf of participants working under the Collective Bargaining Agreement.

 

9.

Type of Plan.

This Plan is maintained for the purpose of providing Life Insurance, Accidental Death and Dismemberment, Hospital, Medical, Dental and Vision Care Benefits in the event of sickness or accident for Active & Retired Employees and their covered dependents.

 

10.

Trust Fund

The Trust's assets and reserves are held in trust by the Board of Trustees (they are listed in item 4 above) of the Operating Engineers Health and Welfare Fund.

 

 11. Plan Amendment and Termination

The benefits provided under the Plan are not contractual benefits.  Therefore, the Board of Trustees reserves the right, in its sole discretion at any time and from time to time: 

To terminate or amend the amount or condition of any benefits even though such termination or amendment affects claims which have already been incurred.

To alter or postpone the method of payment of any benefit.

To amend or rescind any other provisions of the Plan.

The Trustees do not promise to continue the benefits and coverages
in full or in part in the future and rights to future benefits and coverages are not vested.  In particular, retirement or the completion of the requirements to receive a pension benefit under the Pension Plan does not give any participant or former participant any vested right to continued benefits or coverages under the Health and Welfare Plan.

The Board of Trustees are authorized and empowered to:

Construe the meaning of any doubtful or ambiguous provision of the Plan.

Decide on a participant’s entitlement to or application for benefits under the Plan.

Execute all such agreements, adopt and promulgate all such reasonable rules and regulations, take all such proceedings and exercise all such rights and privileges as are necessary in the establishment, maintenance and administration of the Plan.
 

If the Plan terminates, any and all monies and assets remaining in the Trust Fund, after payment of expenses, will be used for the continuance of the benefits provided by the then existing benefit plans, until such monies and assets have been exhausted.

12. Funding Medium

Fee-for-Service hospital, medical, prescription drug, hearing aid, dental, vision, life, accidental death and dismemberment and weekly disability income benefits are paid directly from Trust Fund assets.

Prepaid medical and prescription drug benefits are provided through Health Plan of Nevada and Kaiser.  Prepaid medical benefits are provided through Health Net.

Prepaid dental benefits are provided through Delta Dental and Safeguard.

13.

Organizations through which Benefits are Provided.

The carriers listed below provide fully insured benefits under the Plan. 

Delta Dental
12898 Towne Center Dr.
Cerritos, CA  90703
(Prepaid dental benefits)

Health Net
21281 Burbank Blvd.
Woodland Hills, CA 91367
(Prepaid medical and prescription drug benefits)

Health Plan of Nevada
PO Box 15645
Las Vegas, NV  89114
(Prepaid medical and prescription drug benefits)

Kaiser Permanente
393 E. Walnut St.
Pasadena, CA  91188
(Prepaid medical and prescription drug benefits)

Safeguard Dental
505 N. Euclid St., Suite 200
Anaheim, CA  92803
(Prepaid dental benefits)

The Plan is fully self-insured for the benefits obtained through the carriers listed below.  These carriers administer at least a portion of the benefits for the Plan, but do not insure or otherwise guarantee any of the benefits of the Plan.

Affiliated Health Funds (AHF)
100 E. Corson St.
Pasadena, CA  91103
(Provides access to its network of hospital and medical providers, performs healthcare cost managements services, provider credentialing and claims screening)

Health Care Insights
11075 S. State St., Bldgs. 3 & 4
Sandy, UT  84070
(
Provides prospective review and analysis of medical claims and provides information concerning payments.)

National Medical Health Card
26 Harbor Park Dr.
Port Washington, NY  11050
(Prescription drug benefits

Vision Service Plan of America
100 Howe Ave.
Sacramento, CA  95825
(Administers the vision benefit and provides access to its network of vision providers)

Individual conversion policies are provided by Health Net, Health Plan of Nevada and Kaiser Permanente (hospital and medical coverage).

All of the types of benefits provided by the Plan are set forth in the Table of Contents on Page i. The complete terms of the Vision Care Benefits are set forth in the Agreement with Vision Service Plan. The complete terms of the Prepaid benefits are set forth in the Kaiser Permanente Group Hospital and Medical Service Agreement, Health Net Group Hospital and Professional Service Agreement, the Health Plan of Nevada Service Agreement, the Delta Dental Plans Service Agreement and the Safeguard Service Agreement. The complete terms of the self-funded benefits are set forth in the Rules and Regulations available to any participant at any time.

14.

Fiscal Plan Year.

The fiscal records of the Plan are kept separately for each fiscal Plan Year. The Fiscal Plan Year begins on July 1 and ends on June 30.

 

15.

The Plan's Requirements With Respect to Eligibility for Participation and Benefits.

The eligibility requirements are specified on pages 13-20 of the Plan's Benefit Booklet.

16.

Circumstances Resulting in Disqualification, Ineligibility or Denial or Loss of Benefits.

Loss of eligibility is described on pages 15 and 20 of the Plan's Benefit Booklet.

17.

Procedures to Follow for Filing a Claim.

The procedure to be followed in filing a claim for benefits is outlined on page 26 of the Plan's Benefit Booklet. Claims submitted must be accompanied by any information or proof requested and reasonably required to process such claims.

 

18.

Review Procedure.

If your claim is denied in whole or in part, you will receive a written explanation giving detailed reasons for the denial, specific reference to the Plan provisions on which the denial is based, a description of any additional material or information necessary for you to perfect the claim and an explanation of why such information or material is necessary, as well as an explanation of our claim appeals procedure.  A description of the appeals procedure appears on page 27 of the Plan's Benefit Booklet.

 

19.

Statement of ERISA Rights.

As a participant in the Operating Engineers Health and Welfare Fund, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants shall be entitled to:

 Receive Information about Your Plan and Benefits

Examine, without charge, at the Plan Administrator's office and at other specified locations, such as work sites and union halls, all  documents governing the Plan, including insurance contracts, 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, Collective Bargaining Agreements and copies of the latest annual report (Form 5500 Series) and updated Summary Plan Description. The 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 yourself, spouse or dependents if there is a loss of coverage under the Plan as a result of a qualifying event.  You or your dependents may have to pay for such coverage.  Review this Summary Plan Description and the documents governing the Plan on the rules governing your COBRA continuation coverage rights.

Reduction or elimination of exclusionary period of coverage for preexisting conditions under your group health plan, if you have creditable coverage from another plan.  You should be provided a certificate of creditable coverage, free of charge, from your group health plan or health insurance issuer when you lose coverage under the Plan, when you become entitled to elect COBRA continuation coverage, when your COBRA continuation coverage ceases, if you request it before losing coverage, or if you request it up to 24 months after losing coverage.  Without evidence of creditable coverage, you may be subject to preexisting condition exclusions for 12 months (18 months for late enrollees) after your enrollment date in your 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 employee benefit plan. The people who operate your Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer, your union or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA.

 Enforce Your Rights

bullet

If your claim for a welfare benefit is denied in whole or in part, you have 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.  

bullet

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report from the Plan and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. 

bullet

If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or Federal court.  In addition, if you disagree with the Plan’s decision or lack thereof concerning the qualified status of a medical child support order, you may file suit in a state or Federal court. 

bullet

If it should happen that Plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a state or Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.  

Assistance with Your Questions

bullet

If you have any questions about your Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance with obtaining documents from the Plan, you should contact the nearest office of the Office of Pension and Welfare Benefit Programs, U.S. Department of Labor, listed in your telephone directory or the 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.  You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Pension and Welfare Benefit Administration or on the Web at  Office of Pension-Welfare Benefit Programs, U.S. Department of Labor.