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Plan Administration

There may be times when you need information about how your Teamsters benefits are administered. For your convenience we have listed the information in this section.

Plan Administration and Named Fiduciary
The Teamsters Health and Welfare Fund is administered by a joint Board of Trustees in accordance with the terms of the Agreement and Declaration of Trust of the Teamsters Local 170 Health and Welfare Fund plus this Summary Plan Description, which together compose the official ERISA Plan Document. The Board of Trustees includes three Union representatives and three Employer representatives who serve as the named fiduciaries under ERISA. The Board of Trustees has delegated certain day–today administrative functions to the Administrator of the Fund.

The address and telephone number for the Board of Trustees is:

Board of Trustees
Teamsters Local 170 Health and Welfare
PO Box 1046, Worcester, MA 01613
Telephone: (508) 791–3416

Agent for Service of Legal Process
If for any reason you wish to seek legal action you may serve legal process upon the Plan Administrator. If your action relates to an HMO included in the program you can also serve legal process on the HMO:

Blue Cross Blue Shield Blue Choice New England Plan 2
Landmark Center
401 Park Drive, 01/08
Boston, MA 02215-3326

Fallon Health & Life Assurance Company
10 Chestnut Street
Worcester, MA 01608

Plan Year

The plan year is January 1 through December 31.

Employer and Plan Identification Numbers

  • The Board of Trustees’ employer identification number is 04–2219623. The Plan number for all Plans is 501.

Plan Contributions
Collective Bargaining Agreements(s): The plan is (partially) maintained as a result of a Collective Bargaining Agreement (CBA) between Teamsters Local 170 and participating employers, with various dates and as subsequently amended. You may obtain a copy of the CBA upon written request to the Plan Administrator. A reasonable charge will be made for copies of the agreement. You may also examine the CBA, without charge, during regular business hours at the Fund Office.

Upon written request, the Fund Office will provide you with information as to whether a particular employer is contributing to the Plan on behalf of participants working under a Collective Bargaining Agreement.

Benefit Payment
All benefits are provided from the Fund’s assets, which are accumulated under the provisions of the Collective Bargaining Agreements. Assets are held in a trust fund for the exclusive purpose of providing benefits to covered participants and paying reasonable administrative expenses.

Financial Information
The Fund’s assets and reserves are invested on behalf of the Fund by qualified investment managers who were authorized and approved by the Board of Trustees.

Plan eligibility requirements
Are shown in the Participation Section of this Summary Plan Description (SPD).

Plan Benefits
This portion of the plan provides Group Life, Accidental Death and Dismemberment, Weekly Income, Medical, Prescription, Dental and Vision benefits. This SPD contains a detailed description of your benefits. If you have lost or misplaced your certificate/booklet, you may obtain a new copy, without charge, from the Plan Administrator.

Loss of Benefits
The plan sponsor reserves the right to change or eliminate benefits under the plan and may terminate the entire plan or any portion thereof.

Plan Costs
Participating employers contribute at a fixed rate per hour toward the cost of the plan.

Plan Funding
Benefits are provided from the Fund’s assets which are accumulated under the provisions of the Collective Bargaining Agreement and the Trust Agreement and held in a Trust Fund for the purpose of providing benefits to covered participants and defraying reasonable administrative expenses. Some of the benefits are provided through insurance policies.

Severability
Should any provision in this Trust Agreement or in the Benefit Plan or rules and regulations adopted hereunder, or in any Collective Bargaining Agreement be deemed or held to be unlawful or invalid for any reasons, such fact shall not adversely affect the provisions herein and therein contained unless such illegality shall make impossible or impractical the functioning of the Trust and the Benefit Plan, and in such case the appropriate parties shall immediately adopt a new provision to take the place of the illegal or invalid provision.

Final Note

If you do not understand English or have questions about the benefits or rules of the Plan, contact the Fund Office for assistance. Nothing in this SPD is meant to interpret, extend or change in anyway the provisions expressed in the Plan and Trust Agreement or in any insurance policies purchased by the Fund. The Trustees reserve the right to amend, modify or discontinue all or part of the Plan, by a majority vote, whenever conditions so warrant, in accordance with the terms of the Plan and Trust Agreement.

No local Union Officer; Business Agent; Local Union Employee; Employer or Employer Representative; or Plan Office Personnel Consultant or Attorney is authorized to speak for, on behalf of, or to commit the Plan Trustees on any matter relating to the Plan without the express authority of the Trustees.

Only the Trustees of the Plan may interpret Plan provisions, including determining eligibility for benefits and the right to participate in the Plan; the manner in which hours are credited; eligibility for any benefit; discontinuance of benefits; status as a covered or non covered employee; the level of benefits; and the interpretation and application of rules and regulations to a particular claim or application.

 
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