Health & Welfare Plan
Life, Weekly Disability and AD&D Benefits
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The following benefits are for Active Employees only. There are no life insurance or Accidental Death and Dismemberment benefits for Retirees. (See Retiree Death Benefit.)
There is no life insurance coverage under the COBRA Continuation Plan.
Life Insurance
Death of Active Employee
Upon the death of an Active Employee, an $8,000 group life insurance benefit will be paid to the Employee’s beneficiary.
The beneficiary may be any person or persons you name and may be changed at any time. The beneficiary must be designated, in writing, on the form provided by the Fund Office. If no beneficiary is designated or if the designated beneficiary dies before the Employee, the beneficiary will be the surviving person or persons in the order listed below:
- Spouse
- Children
- Parents
- Brothers and sisters
- Executor or administrator
If two or more persons are entitled to receive benefits they will share equally unless the Employee designates otherwise.
If a covered dependent dies while eligible in the Plan or within 31 days following termination of such eligibility, the Fund will provide the following benefits to the Active Employee:
| Spouse |
$2,500
|
| Children: | |
|
$100
|
|
$1,000 |
Accidental Death and Dismemberment Benefits for Active Employees
If you incur any of the following losses through accidental means on or off the job, the following benefits will be paid. The loss must occur within 90 days after the accident. Payment will be made regardless of any other benefits you may receive.
| Loss of Life | $8,000 paid to your beneficiary |
Loss of:
|
$8,000 paid to you |
Loss of:
|
$4,000 paid to you |
If you suffer more than one loss in an accident, payment will be made only for the one loss for which the largest amount is payable.
Your beneficiary may be any person or persons you name and may be changed at any time. The beneficiary must be designated, in writing, on the form provided by the Fund Office. If no beneficiary is designated or if the designated beneficiary dies before the Employee, the beneficiary will be the surviving person or persons in the order listed below:
- Spouse
- Children
- Parents
- Brothers and sisters
- Executor or administrator
If two or more persons are entitled to receive benefits they will share equally unless the Employee designates otherwise.
Exclusions
No benefit will be paid for any accidental death or dismemberment loss caused from:
- Disease
- Drugs, chemicals, poisons or inhalation of gases
- Injury that is sustained in the course of any medical or dental diagnosis or treatment
- Injury that is sustained while you are in any aircraft unless you are a paying passenger on a regularly scheduled flight
- Injury that is intentionally self-inflicted while sane or self-inflicted while insane
- Injury that results from your commission of a crime
- Any act of war or any release of nuclear energy
- Loss of Life
Weekly Disability Benefit (Nevada Only)
Disabled participants who live in California receive a disability benefit directly from the State. Nevada does not have a State Disability program, so the Fund receives an additional contribution on behalf of Southern Nevada employees. This additional contribution funds a Weekly Disability program for eligible participants who worked for Southern Nevada employers.
Benefits
$70 per day or $490 per week; up to a maximum benefit of 52 weeks.
There is a 7-day waiting period for disability due to illness (payments begin on the eighth day). There is no waiting period for injury.
Benefits are reduced by any federal disability benefits.
Total Disability Definition
Total disability means that the eligible individual is unable, due to illness, injury or pregnancy, to perform the substantial and material duties of the occupation he or she was engaged in when the disability occurred and that the disabled individual is not engaged in any gainful occupation.
Exclusions
No weekly disability benefit will be paid for any period during which the Active Employee is not under the care of a physician or other medical practitioner.
No weekly disability benefit will be paid for a disability that is caused by or related to any injury or sickness that:
- Is intentionally self-inflicted while sane or that is self-inflicted while insane
- Results from any act of war
- Results from your commission of a crime
- Results from the release of nuclear energy
- Results from or arises out of any past or present employment or occupation for compensation or profit
Filing a Claim
Nevada Weekly Disability claim forms are available from the Las Vegas or Pasadena Fund Offices or the Las Vegas District Office of I.U.O.E., Local 12, or from the Fund’s website at www.oefi.org. You and your doctor must complete the form and return it to the Pasadena Fund Office.