FREQUENTLY ASKED QUESTIONS

The Plan has entered into an agreement with Anthem Blue Cross | Blue Shield of Wisconsin.

For Classes A & C: Your deductible is $500 per person per calendar year- $1,500 per family per calendar year if in-network.
For Class A Reduced Cost: Your deductible is $3,000 per person per calendar year- $9,000 per family per calendar year if in-network.
There is no deductible for Class D (Medicare Supp.).

For Classes A & C: The out-of-pocket limit per calendar year is $2,800 per person and $8,100 per family if in-network.
For Class A Reduced Cost: The out-of-pocket limit per calendar year is $4,300 per person and $9,600 per family if in-network.

You and all of your eligible dependents are covered under your benefits as defined by the Plan.

Visit Anthem, login to your account, then search within the 'Find a Doctor' tool.

The Plan receives limited information from medical providers, and as a result, when the Plan receives a bill with a diagnosis of an accident or a possible accident, the Plan is required to obtain additional information, in writing, from the Participant. The Plan must determine, through the completion of the accident letter, whether the accident was work related, auto related or third-party liability.

All dependent children are eligible to be covered until age 26 whether or not they are full-time students, married, living at home, financially dependent on the eligible employee, or eligible for coverage under any other employer's plan. The current rules for coverage of grandchildren will not change.

If you meet the eligibility requirements there is a weekly disability benefit available for a maximum of 26 weeks. Short-term disability benefits are not payable for alumni and non-bargaining unit employees nor for those under the reduced cost option. Please refer to the SPD or call your claims adjuster for additional information.

Dental and vision benefits are optional and are not available separately. There is an annual open enrolment period in which you can elect these benefits. If you enroll you will be required to keep the optional benefits for a minimum of two years. The payment for this optional benefit can be deducted from your paycheck on a pre-tax basis or deducted from your dollar bank.

• The Plan provides a wide range of EAP services and resources to you and your household at no cost through Anthem EAP:
• Counseling
• Legal consultation
• Financial consultation
• ID recovery
• myStrength
• Dependent care and daily living resources
• Crisis consultation
• Other anthemEAP.com resources

If you receive care at a provider who does not participate with Anthem Blue Cross | Blue Shield of Wisconsin, submit an itemized bill to Local 434 Health & Welfare Fund at Wilson-McShane Corporation, 3001 Metro Drive, Suite 500, Bloomington, MN 55425. The itemized bill should have the employee’s ID and group number as it appears on your medical card. If the provider participates with HealthEOS, the provider will submit the claim for you.

Delta Dental network.

You can see any dentist you wish. However, the Plan uses the Delta Dental Network and the maximum benefit per year is higher if you use a network provider.

The Plan provides life insurance benefits depending on your classification in the Plan. Please refer to the SPD.

If you wish to change the name of your beneficiary, you must send a completed Beneficiary Change Form to the Fund Office.

Participating employers make Supplemental Plan contributions for each hour of work covered under an agreement between the Local 434 and the employer or a Participation Agreement with the Fund. The amount of hourly contribution is specified in your collective bargaining agreement, participation agreement, or other written agreement with the Trustees of the Plan

Your Account also may be funded by elective deferral contributions (401k) into the Plan. You may elect to have your employer make a pre-tax payroll deduction in $0.50 increments from $0.50 to $7.00/ hour or in $1.00 increments from $7.00 to $20.00 per hour.

You are vested in all amounts credited to your account regardless of your years of employment.

As of 2022, the limit is $20,500 (or $27,000 for “catch up contributions” if over age 50). If the limit is exceeded the excess contributions will be refunded.

If the plan is qualified, you may rollover a prior plan into this Plan. To initiate a rollover, you must complete a Rollover Form along with supporting documentation and provide it to the Fund Office.

To change your investment allocation you will need to contact Milliman, the Fund Recordkeeper, either by phone at (866) 767-1212 or online: https://www.millimanbenefits.com

You are eligible for payment of your Accounts upon:

• You reach age 55 and retire from employment with a contributing employer;
• You are age 59 ½
• You become totally and permanently disabled as evidenced by receipt of a Social Security disability award.
• You have terminated employment covered by the Plan for three consecutive months.
• You are eligible for a hardship distribution
• You die

To apply for a withdrawal, you will need to complete an Application for Benefits. Please complete the form and mail along with any noted documentation to the Fund Office.

The Plan does not provide loans.

In certain circumstances, you can request a hardship distribution from your account. To be eligible for a hardship distribution, you must experience a financial hardship which is defined as an immediate and heavy financial need to pay for one of the following:

• Payment of unreimbursed medical expenses for you, your spouse, your dependents or your primary beneficiaries (i.e., not contingent beneficiaries) or expenses which are necessary for these persons to obtain medical care;
• Costs related to the purchase of your principal residence (excluding mortgage payments);
• Payment of tuition and related educational fees and expenses for the next 12 months of post-secondary education for you, your spouse, your dependents or your primary beneficiaries (i.e., not contingent beneficiaries). For this purpose, up to two hardship withdrawals per 12-month period are permitted;
• Preventing the eviction from, or mortgage foreclosure of, your principal residence. For this purpose, up to two hardship withdrawals per 12-month period are permitted;
• Payment of funeral or burial expenses for your deceased parent, spouse, child, dependents or primary beneficiaries (i.e., not contingent beneficiaries);
• Expenses for the repair of damage to your principal residence that would qualify for the Code section 165 casualty deduction (determined without regard to Code section 165(h)(5) or whether the loss exceeds 10% of your adjusted gross income);
• Payments necessary to remove a levy issued to your bank account by the Internal Revenue Service;
• Reasonable and necessary adoption expenses related to the adoption of a dependent child under age 18; or
• Expenses and losses (including loss of income) incurred by the employee on account of a disaster declare by the Federal Emergency Management Agency ("FEMA") under the Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law 100- 107, provided that the Participant's principal residence or principal place of employment at the time of the disaster was located in an area designated by FEMA for individual assistance with respect to the disaster.
• Payment of attorney's fees exceeding $30,000 related to criminal defense of felony charges.

Yes, the payment you receive from the plan will be subject to mandatory withholding of 20% for federal income taxes. You can avoid mandatory withholding only if you arrange to have your benefit transferred directly to an IRA or an eligible retirement plan.

In order to change your mailing address, you must complete a Change of Address Form. You may print and complete the form, or you may contact the Fund Office and a form will be mailed to you.

Complete a Beneficiary Designation Form and mail to the Fund Office.

If you have any questions about your eligibility, benefits or claims, contact the Fund Office at (952)854-0795.