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INFORMATION REQUIRED BY THE EMPLOYEE
RETIREMENT INCOME SECURITY ACT OF 1974
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1. |
Name of Plan. |
This Plan is known as the Operating Engineers Health and Welfare Fund.
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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.
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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
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4. |
Names, Titles and Addresses of Any Trustee or Trustees. |
As of November 1, 2005, the Trustees of this Plan are: |
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EMPLOYER TRUSTEES |
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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 |
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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 |
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John Nelson
FCI CONSTRUCTORS, INC.
2585 Business Park Dr.
Vista, CA 92081 |
Mitch White
MANSON CONSTRUCTION
1617 Pier "D" Street
Long Beach, CA 90802 |
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UNION TRUSTEES |
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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 |
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5. |
Identification Numbers. |
The number assigned to the Plan by the Internal Revenue Service is 95-6034886.
This Plan Number is 003.
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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.
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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.
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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.
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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.
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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.
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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:
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To terminate or amend the amount or condition of any benefits
even though such termination or amendment affects claims which have already
been incurred. |
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To alter or postpone the method of payment of any benefit. |
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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:
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Construe the
meaning of any doubtful or ambiguous provision of the Plan. |
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Decide on a
participant’s entitlement to or application for benefits under the Plan. |
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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.
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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. |
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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. |
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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. |
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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.
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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. |
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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. |
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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.
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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.
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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
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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. |
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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. |
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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
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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. |
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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
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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.
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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.
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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.
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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.
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Assistance with
Your Questions
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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. |
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