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Welfare Fund Application
Benefits are $150 per calendar week or $21.43 per workday. Maximum of 26 weeks per disability.
Paid to the last designated beneficiary for employee or retired employee as per the below schedule.
|Employees Years of Coverage||Amount|
|2 months to 1 year||$1,000|
|1 year to 2 years||$2,000|
|2 years to 3 years||$3,000|
|3 years to 4 years||$4,000|
|4 years or more||$6,000|
ACCIDENTAL DEATH OR DISMEMBERMENT BENEFITS
For Employee Only:
|Loss of Life||Scheduled death benefit above|
|For Loss of both hand, or both feet|
or, loss of one hand or foot and
|sight in one eye||Scheduled death benefit above|
|For loss of one hand, one foot, or|
|sight in one eye||50% of scheduled death benefit above|
ORTHODONTIC BENEFITS (OVER AGE 19 OR NON-MEDICALLY NECESSARY)
Lifetime maximum of $1,500.
ORTHODONTIC BENEFITS (UNDER AGE 19 AND MEDICALLY NECESSARY)
|Up to $1,500||Paid at 100%|
|$1,501 - $3,000|
Paid at 40%
|$3,001 +||Paid at 20%|
Covered up to $15 per visit, up to 24 visits per calendar year.
Covered up to $15 per visit, up to 12 visits per calendar year.
|At Pharmacy||Mail Order|
|Generic||Greater of $5 or 20% of Cost||$5|
|Preferred Brand||Greater of $5 or 20% of Cost||$10|
|Non-Preferred Brand||40% of Cost||$25|
|Up to $3,000|
Subject to Co-pays above
|$3,001 - $6,000||60% co-insurance (Plan pays 40%)|
|$6,001 +||80% co-insurance (Plan pays 20%)|
PRE-PAID LEGAL SERVICES
SCHEDULE OF BENEFITS
Note: These benefits are not defined and subject to modification/change by the Fund's Board of Trustees.
Copyright D. McCredo. All rights reserved.
ALLIED BUILDING INSPECTORS
New York, New York, United States
Phone: 212. 233.2690
IMPORTANT NOTE REGARDING BENEFIT ELIGIBILITY
In order to qualify for benefits, an employee must have on file with the Union Welfare Fund Office, a signed enrollment form providing data as to social security number, birth date, family status, and beneficiary. Before coverage for dependents can begin, a copy of marriage certificate/domestic partner certificate required for spouse and birth (naming the member as parent) or adoption certificates for children are required.