Summary Plan Description Table of Contents
Benefit Claims and Appeals Procedure
Does a Participant need to file an application to receive benefits?
Not ordinarily. If the Participant opened an account at the designated bank, vacation benefits are paid to the account automatically on a monthly basis. If a Participant or Beneficiary believes that a benefit should have been paid that was not paid, he will need to file an application. Also, a Participant will need to file an application for benefits if the involved benefits had been previously forfeited. In addition, in the case of the death benefit, the Trustees may require an application and other relevant information to be submitted.
What is the procedure followed by the Administrative Manager if an application for benefits is filed?
If an application for benefits is filed, and is denied in whole or in part by the Administrative Manager, notice of denial will ordinarily be provided you by the Administrative Manager within ninety (90) days of the application unless special circumstances require an extension of time for processing. Written notice of an extension shall be provided before the expiration of the initial 90 day period and shall not extend more than 90 days following the expiration of that period. If applicable law mandates different times or procedures they will be followed. A notice of denial of benefits shall be in easily understood language, indicate the reasons for denial, the specific provisions of the plan on which denial is based, the remedies available for requesting review of denial, including possible court action, any information necessary to perfect your claim and any reason why this benefit is necessary.
How can a Participant or Beneficiary appeal if his application for benefits is denied in whole or in part or if the amount of benefits paid is less than the full amount of benefits which the Participant or Beneficiary believes should be received under the Plan?
If a Participant or Beneficiary’s application for benefits is denied in whole or in part or if the amount of benefits received reflects a denial in whole or in part of the full amount of benefits requested, he may make a written request to the Board of Trustees for a review of denial of benefits. This written request must be made within 60 days of the day written denial of benefits from the Administrative Manager is received or the benefit payment is received which is believed to be inadequate. The request should refer to the provisions of the Plan on which the appeal is based and the facts which support the appeal. If applicable law mandates different times or procedures they will be followed.
What rights does a Participant or Beneficiary have after an appeal is filed with the Board of Trustees?
A Participant or Beneficiary may examine pertinent documents and submit relevant issues and comments in writing. He also may have a representative act on his behalf in pursuing any of the rights related to the Claims and Appeal Procedure, including those discussed in the answers to the previous questions.
How will the Board of Trustees resolve the appeal?
The Board of Trustees will either review the appeal themselves or have the review handled by an administrative committee of the Trustees. A decision will ordinarily be made within 60 days after the day the Board of Trustees receives the written request for review. A delayed decision will be rendered no later than 120 days after the day the Board of Trustees receives the request for review unless the Participant or Beneficiary causes or contributes to the postponement. The Participant or Beneficiary will receive written notice in case there is a delayed decision and this notice will be furnished prior to the expiration of the normal 60 day decision period. If applicable law mandates different times or procedures they will be followed.
Is there arbitration regarding a decision of the Board of Trustees?
A Participant or Beneficiary may seek final and binding arbitration regarding a decision of the Board of Trustees or its administrative committee under the arbitration procedures set forth in the Trust Agreement. Arbitration must be requested within 60 days of the decision of the Board of Trustees or its administrative committee. The Trustees and the Participant or Beneficiary will each select an arbitrator who will then either agree upon a third neutral arbitrator or petition the Circuit Court of DuPage County, Illinois for appointment of an arbitrator. The questions for the arbitrator will be whether the Trustees or committee erred in deciding a legal issue, acted arbitrarily or capriciously in the exercise of their discretion or whether the findings of fact were supported by substantial evidence in the record. The decision of any two arbitrators shall be final and binding on the Trustees and the participant or beneficiary. Each party must compensate its own arbitrator and will equally split the expenses of the third arbitrator.
Is it necessary to use the appeal procedures before an action is brought in court to collect benefits?
Yes.
GENERAL MATTERS APPLICABLE TO THE PLAN
Are the Trustees’ decisions conclusive and binding?
Subject to the requirements of the law, the decisions of the Trustees shall be final and binding on all parties. The Trustees are empowered to exercise the fullest extent of discretion authorized under any applicable law in carrying out their responsibilities.
Can my benefits be assigned or attached?
The Trustees have taken all steps available to them under the law to protect your benefits. You may not assign the benefits prior to distribution. Once benefits have been distributed to your account at the designated bank they are no longer plan assets and will likely be subject to assignment or attachment.
What happens to my benefits in the case of my incompetency or incapacity?
The plan authorizes the Trustees, in their discretion, to direct benefits to your maintenance utilizing methods set forth in the Trust Agreement.
Can the Plan be amended?
Yes. However, no amendment may alter the basic principles of the Trust Agreement, conflict with collective bargaining agreements as these agreements affect contributions to the Fund, be contrary to laws governing the Fund or contrary to agreements entered by the Trustees.
Can the Plan be terminated?
Yes. The plan may be terminated by a written instrument executed by the Union and Employer Association. Termination may also be made by a written instrument executed by all the trustees when there is no longer a written agreement requiring contributions to the Fund.
What happens if the Plan terminates?
The obligations of the Plan shall be paid. The remaining assets will be distributed in a manner determined by the Trustees which will in their opinion best effectuate the purpose of the Fund. However, no part of the assets shall be used for purposes other than the exclusive benefit of participants and beneficiaries or administrative purposes. Further, no assets shall inure to the benefit of any Employer or to the Union.