Have a question? First check to see if your question can be answered in the following list.
If it's not there, let us know. Plan Office
As we receive inquiries from our members, we will post the most common questions, with the answers here.
Scroll down through the Q&A or click on a specific category on the right.
Q. What Network are we in?
A. The Plan has entered into an agreement with UnitedHealthcare/UMR to provide you with access to the Choice Plus PPO network of providers.
Q. Do I have to go to a network provider?
A. No. However, if you utilize an out-of-network provider you and the Plan may pay more because there is no discount.
Q. What is our deductible?
A. Your deductible is $300 per person per calendar year - $900 per family for full time employees.
Q. What is the most I could pay in a year for my major medical benefits?
A. The annual out of pocket is $2,500 per person. Full-Time employees have an annual family out of pocket of $5,000. Infertility treatment does not apply towards the out of pocket.
Q. Who is covered under my benefits?
A. For Full-Time Employees: Yourself and all your eligible dependents as defined by the Plan.
A. For Part-Time Employees: Yourself as defined by the Plan.
Q. How can I find a doctor?
A. The link below will take you to the network web site where you can look through provider directories.
Go to www.umr.com
Q. Why do I have to complete a form after an injury/accident claim?
A. 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.
Q. How long are children covered under the Plan?
A. A Full-Time eligible employee's children will continue to be covered under the Plan for as long as they meet the Plan’s definition of a dependent child, typically until they reach age 26. See your Summary Plan Description or call the Fund Office for more information.
Q. Is there a short-term disability benefit available?
A. If you meet the requirements as an eligible Full-Time employee there is a weekly disability benefit available for a maximum of 26 weeks. Please refer to the SPD or call your claims adjuster for additional information.
Q. How do I file a vision claim myself?
A. If you receive care at a provider who does not participate with UnitedHealthcare, submit an itemized bill to 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 UFCW #1189 UnitedHealthcare/UMR card. If the provider participates with UnitedHealthcare, the provider can submit the claim directly to UnitedHealthcare/UMR.
Q. Where can I go for vision services?
A. Anywhere.
Q. Do we have a max on our vision benefits?
A. Yes. The Plan will pay $300 per person per calendar year of eligible vision expenses for Full-Time employees and their dependents.
Q. What network are we in?
A. Delta Dental network.
Q. Where do I send my dental bills?
A. Wilson-McShane Corporation, Attn: UFCW #1189 Dental Department, 3001 Metro Drive, Suite 500, Bloomington, MN 55425.
Q . Do I need a dental card?
A. You will have one UnitedHealthcare/UMR ID card for your medical and pharmacy benefits and a separate Delta Dental ID card for your dental benefits.
Q. What dentists can I go to?
A. You can see any dentist you wish, however, the Plan uses the Delta Dental Network. By choosing a dentist in the network, benefits are payable at the negotiated Delta Dental rate.
Q. What is the coverage period for the schedule of benefits?
A. Calendar year.
Q. How long are children covered under the dental Plan?
A. A Full-Time eligible employee's children will continue to be covered under the Plan for as long as they meet the Plan’s definition of a dependent child, typically until they reach age 26. See your Summary Plan Description or call the Fund Office for more information.
Q. If I don’t use all my benefits, can they rollover to the next year?
A. No. Unused benefits cannot be rolled over to the next year.
Q. Can I use my dental insurance out of state?
A. Yes.
Q. Is there any procedure that my dental insurance won’t cover?
A. Please refer to your SPD.
Q. I just met the eligibility requirement. Why aren’t I eligible for insurance?
A. Please call the Plan Office at (952) 854-0795 or toll-free at (800) 535-6373 or refer your Summary Plan Description Booklet for a detailed description of your eligibility.
Q. How will I know if I lose eligibility through the Plan?
A. Participants are sent a Loss of Coverage Notice at the end of their last eligible month. This is another reason why it is so important to keep the Plan office updated with your current address.
Q. How much do I pay in for my Health Insurance?
A. The UFCW #1189 Health and Welfare Plan is a multi-employer, self-insured plan, and eligibility for benefit coverage is determined by the number of hours worked and reported to the Plan. The amount of your required pre-tax contribution is detailed in your Collective Bargaining Agreement.
Q. How much do I pay for my child(ren)’s Health Insurance?
A. When a Full-Time participant satisfies the Plan’s eligibility requirements, all dependents (as defined by the plan) are also eligible at no cost to you.
Q. How do I add or delete dependents?
A. If you are a Full-Time employee and you need to add or remove dependents, you must notify the Plan Office in writing. You should be prepared to provide documentation in the form of a birth certificate, decree of adoption, marriage license, divorce decree, etc. Since the Plan provides Benefits to Eligible Dependents, the Plan Office must know who your dependents are at all times.
Q. How do I change my beneficiary?
A. If you wish to change the name of your beneficiary, you must send a completed Beneficiary Change Form to the Plan office. If you fail to notify the Plan Office of your wishes in writing, the Plan office will be unable to pay any life insurance Benefits to anyone other than the person(s) in your latest written notification to the Plan Office prior to the time of your death.
Q. When will I become eligible to receive my benefit from the UFCW Local 1189 Defined Contribution Plan?
A. You or your beneficiaries are eligible to receive your benefit when one of
the following events occur:
- You retire from employment after attaining age 55
-
You terminate employment within the trade and geographic jurisdiction of
the union for at least 90 consecutive days
-
You die
-
The Plan terminates
- You are age 65 or older and are still working for a contributing employer
Q. How much will I receive?
A. You will receive:
- 100% of your (K) benefit, as of the date of
distribution. The (K) portion is the contribution you make to the Plan.
- In order to have a right to receive the proceeds in your account (A) you must become vested in those benefits. Please see section below regarding
vesting.
Q. What is vesting?
A. Vesting is:
The percentage of (A) funds you will be entitled to at the time of your distribution.
The following vesting schedule applies to Account A balances if a Participant has not earned at least one Hour of Service on
or after January 1, 2009:
Year of Vesting Service |
Vesting Percentage |
Less than 3 |
0% |
3 |
33 1/3% |
4 |
66 2/3%
|
5 or more |
100% |
The following vesting schedule applies to Account A balances if a Participant has earned at least one Hour of Service on
or after January 1, 2009:
Year of Vesting Service |
Vesting Percentage |
One or less |
0% |
2 |
25% |
3 |
50% |
4 |
75% |
5 or more |
100% |
Alternatively, any Participant continuing employment through age 65 in a position for which contributions are owed to the Plan will become 100% vested at that time.
Q. Is my benefit from the UFCW Defined Contribution Plan taxable?
A. Taxation of benefits is as follows:Whenever you receive a distribution from the Plan, it will normally be taxed as ordinary income. You will receive 80% of the payment because the Plan Administrator is required to withhold 20% of the payment and send it to the IRS as income tax withholding to be credited against your taxes.
In addition you may have to pay an extra 10% federal tax due to early withdrawal.
If instead, you choose to roll over the payment, the money in your account will be
transferred directly to another IRA or qualified retirement plan, and you will not be taxed until you take it out of the IRA or plan that accepted your rollover.
Since tax laws change frequently, you should consult a tax expert to determine your exact tax liability.
Q. When should I call the Fund Office to request an application to receive my benefit from the UFCW Defined Contribution Plan?
A. Call the Fund Office when you become eligible to receive the benefit as outlined in question number 1 above.