POLICY INFORMATION

It is your responsibility to notify Union One Benefits Management if your employment, union status, contact information, or salary changes. Failure to properly notify Union One will result in loss of payments and/or insurance coverage. Notification to Union One must be made by phone at (224) 770-5305 and/or by email at info@unionone.com.

Income Verification Notice

In the event a claim is filed, you will be required to verify your income by providing your prior year’s W-2 and/or 3 full months of paystubs. Benefit payments are subject to change based on the income you can verify at time of claim.

Benefits Offsets, Reductions and Overpayments

Benefits may be reduced where offsets apply. The rates illustrated do not reflect any applicable offsets that may be available to you. It is your responsibility as the claimant to notify Union One and the Insurance Company of any other income sources you are receiving; failure to do so may result in an overpayment that you will be required to repay. Please review the Group Policy for further information. If you have any questions regarding offsets, please call the Customer Service Center at (224) 770-5305.

As an individual Member of the union, if you have voluntarily elected to participate and pay for coverage, it is your responsibility to review the group policy and its provisions.

Short-Term Disability – Pre-Existing Guidelines

Short-Term Disability has a Pre-Existing Condition limitation of 12 months. In order for a pre-existing condition to be covered, you must be an eligible Member of the group and have paid Short-Term Disability payments for 12 consecutive months prior to your date of disability, or you must be treatment-free for the 3 months prior to your coverage effective date (Look Back Period) for the disabling condition.

Long-Term Disability – Pre-Existing Guidelines

Long-Term Disability has a Pre-Existing Condition limitation of 12 months. In order for a pre-existing condition to be covered, you must be an eligible Member of the group and have paid Long-Term Disability payments for 12 consecutive months prior to your date of disability, or you must be treatment-free for the 3 months prior to your coverage effective date (Look Back Period) for the disabling condition.

More Pre-Existing Limitation Information

These Pre-Existing Condition limitations also apply to any benefit increase.

• Pre-Existing Conditions are reviewed by the insurance carrier at time of claim, which will require disclosure of all medical records, doctors’ notes and prescription drug history.
• Failing to receive treatment does not preclude you from the Pre-Existing Condition Look Back Period.

Please review the Group Policy for further information. If you have any questions regarding Pre-Existing Condition limitations, please call (224) 770-5305.

Learn more about your Long-Term Disability Policy

This information is intended to help you understand the transition process from own-occupation to any-occupation.

Your Union Long-Term Disability Policy (5-year duration option only) through Sun Life contains a 2 year “own-occupation” period within the definition of disability; which simply means that during the first 2 years of a Long-Term disability claim, your disabling condition must prevent you from performing the “essential duties” of YOUR specific occupation (as defined by the Department of Labor). After 2 years of receiving Long-Term Disability benefits, you would transition from “own-occupation” to “any-occupation”.

Generally, the following criteria is used when determining whether you can work in another (“any”) occupation:

1. Occupations exist within your job market (approximately 60 miles commute or less, considering your length of travel to work prior to disability) that you could perform with your disability/functionality restrictions.
2. Occupations exist that you can perform the majority of the substantial and material duties for and have the education, training, or experience to perform.
3. Occupations exist that pay a reasonable amount in accordance to policy guidelines.

The transition from the own-occupation definition of disability to the any-occupation definition does not in itself eliminate your ability to receive benefits. This transition is a change in the criteria used to adjudicate your disability and may or may not cause benefits to terminate (depending on each unique situation and the criteria above). Job openings/availability are not guaranteed nor does the policy protect against whether you successfully secure employment.

This “own occ/any occ” provision of the policy is intended to help both those claiming disability benefits and those who are not claiming disability benefits. This policy provision incentivizes individuals who are off on disability to either rehabilitate and get back to work at their current occupation or utilize their training/education to find gainful employment in another field. For those Members who are not on disability, this provision helps to ensure that disability coverage remains affordable and in-force. It is important for the long-term sustainability of the policy that individuals on disability try to return to the workforce when the ability exists to find gainful employment as outlined in the above criteria.

Additional Return-To-Work services are typically provided by the insurance company at no cost. Among others, most insurers offer programs and services to assist disabled Members and help them return to full productivity, and their Vocational Rehabilitation Benefits provide individually tailored programs to assist Members on LTD with successful recovery and re-entry to the workplace. Additionally, the insurance company typically employs vocational rehabilitation professionals to review each claim independently and work with the claimant to determine the most appropriate course of action. Everyone wins when disabled Members are working toward re-entry into the workforce!

This is a Voluntary Group Term Life Insurance plan offered through your union. As such, this plan should not serve as your primary source of Life Insurance as the union or insurance company may terminate, cancel or change this policy at renewal. This Life Insurance Plan is designed to give you and your family a guaranteed approved option for additional Supplemental Life Insurance while working and an active Member of your union. Please review all the provisions of this Life Insurance Policy and it is highly recommended that this policy not be used to replace any existing Life Insurance coverage you may have.

When Life Insurance Coverage Ends

If disabled, you may keep your Life Insurance coverage for up to 12 months provided payments continue to be made during that period. Beyond 12 months, your coverage will terminate unless you convert or port your Life Insurance coverage.

If you leave the union or retire, you may convert your Group Term Life Insurance to a Permanent Individual Life Insurance Policy or you may port your coverage. You must elect to convert or port your coverage within 31 days from the date you are no longer eligible to be covered on the group plan (i.e. date of retirement or termination). Please contact the Customer Service Center at (224) 770-5305 for questions about rates associated with converting or porting your Life Insurance coverage.

If you are enrolled in Dependent Life coverage and your dependent is disabled, you can retain your dependent’s coverage beyond age 26 by completing an application. You will have only 31 days from your dependent’s 26th birthday to submit this application.

Note: Typically converting your Group Term Life Insurance to an Individual Permanent Life Insurance Policy is very expensive and only recommended for people who cannot qualify for Life Insurance elsewhere.

Renewal Notice

This is a Group Insurance Plan offered through your union. As such, at renewal your rates and benefits may change or non-renew based on the overall claims experience of the group and/or participation requirements not being met. Further, any substantial change to the makeup of the group, such as a change in the Member demographics, that impacts the underwriting risk of the plan may immediately result in a change to the plan.

At renewal, if you do not call Union One to re-enroll or discontinue coverage, you hereby authorize and give permission to Union One to auto-enroll you in the renewal plan benefits that most resemble your currently elected benefits. Auto-enrollment could result in a potential increase in your monthly or bi-monthly payment drafts. Please understand, this is intended to ensure no Member loses coverage for failing or forgetting to take the time to renew or re-enroll. Given that all benefits are “voluntary” you can cancel or lower your coverage at any time.

Refund Policy

It is the enrolled Member’s obligation to promptly notify us of any changes in status that affect your membership or employment associated with the union. This includes, but is not limited to, resignation, dismissal or termination of employment, layoff, retirement, disability, FMLA leave, leave of absence, military leave, leaving the union, cessation of full union dues payments, improper enrollment, or any other form of separation that prevents active membership in the union or active employment with your employer connected with the union.

Members must provide this notification within 90 days of the qualifying event to be eligible for a refund of insurance premiums. Notifications received within this 90-day period will result in a refund of the insurance premiums paid, minus all technology and transaction fees, which are non-refundable.

Members who improperly enroll are subject to the same refund policy rules. Improper enrollment includes, but is not limited to, providing inaccurate information, failing to meet membership requirements, failing to meet work requirements, failing to meet employment requirements, or violating union membership policies.

Any notification submitted after the 90-day window will result in the forfeiture of any refund. However, refund requests received after 90 days may be reviewed on a case-by-case basis if unforeseen circumstances prevented timely notification.

It is the sole responsibility of the Member to ensure that notifications are submitted within the allotted 90-day period following any qualifying event. Failure to do so will result in the loss of eligibility for a refund of insurance premiums.

To submit a notification or for any questions regarding this policy, please contact the Customer Service Center at (224) 770-5305 or email info@unionone.com.

Loss of Monthly Payments Notice

If you do not contact our office within 90 days of your date of dismissal, date of retirement, date in which you left the IBEW union, there will be no refund for any payments made. It is the sole responsibility of the Member to contact the Customer Service Center at (224) 770-5305 or by email at info@unionone.com within the 90 day allotted time.

Failure to Make a Payment

Participating Members for whatever reason may miss a payment from time to time. The current plan allows for a 60 day grace period to make up any missed payments. After 60 days, all coverage will be cancelled due to non-payment.

Administrative & Transaction Costs

All administrative and transaction fees are included in your monthly payment. These fees cover the costs associated with, but not limited to, payment processing, payment returns, postage, policy correspondence, claims advocacy and other ancillary expenses associated with the administration of your elections. These monthly fees are applied to all coverages shown on the Benefits Booklet.

Included when payment is collected: Payment Transaction Fee $1.00 per transaction.