The Fund provides members with a life insurance benefit of $10,000 through Standard Life Insurance. Life insurance coverage begins after a six-calendar-month waiting period from your first day of Covered Employment. After this waiting period, eligibility for the life insurance benefit is dependent upon retaining actively working medical coverage with the Fund.
When you enroll for benefits, you’ll be asked to name a person or persons who will receive your life insurance benefit if you should die while covered under the Plan. You may name more than one beneficiary and you may change your beneficiary in writing at any later time. If you name more than one beneficiary, you will need to indicate the percentage that each beneficiary will receive of your benefit.
It’s important that you name a beneficiary. If you do not name one, or if your beneficiary is not living at the time of your death, your benefit will be paid to your survivors as follows:
•Your spouse. If none,
•Your children, in equal shares. If none,
•Your parent(s), in equal shares. If none,
•Your siblings, in equal shares. If none,
•The executor or administrator of your estate.
If you name multiple beneficiaries and one is not alive at the time a claim is made, the deceased person’s benefit will be divided evenly among the remaining beneficiary or beneficiaries.
If you leave Covered Employment, your life insurance benefit will end thirty-one (31) calendar days after your last day of Covered Employment.
Converting Your Life Insurance
If you stop working for an employer contributing to the Fund, you may change your group life insurance provided by the Fund to an individual life insurance policy, without having a medical examination, during the 31-day period after life insurance benefits under the Fund terminate. Life insurance benefits will be paid in the event your death occurs during the thirty-one days after coverage terminates. You may select any type of individual policy then customarily being issued by Standard Life Insurance, except term insurance or a policy containing disability benefits. You are responsible for paying the premiums for this conversion. The individual policy premium will be the same payment as it ordinarily would be if you applied for an individual policy at that time.
(If you have converted your life insurance protection to an individual policy and again become eligible for insurance under this Fund while the converted policy is in force, you should notify the Central Administration office.)
If you’re disabled, to assure continuous protection, you may change your group life insurance coverage provided by the Fund to an individual life insurance policy issued by Standard Life Insurance, during the thirty-one days following the end of the twenty-six week disability period.
If you immediately convert to an individual policy and later on apply and are approved for continued no-cost coverage because of a disability, the individual policy will be voided and any premium payments made will be returned to you.
Waiver of Premium when Totally Disabled
If you become Totally Disabled while insured by Standard Life Insurance and prior to reaching age sixty, your life insurance will be continued without payment of premium while your Total Disability continues. The initial continuation of your insurance under this provision will be for twelve months from the date the disability begins. “Totally Disabled” and “Total Disability” mean your complete inability, due to injury or illness, to engage in any business, occupation or employment, even on a part-time basis, for which you are qualified or become qualified by reason of education, training or experience, for pay, profit or compensation.
No coverage under this Waiver of Premium provision will be provided until the following requirements have been satisfied:
- You must remain totally disabled for at least nine consecutive months.
- You must submit satisfactory written proof of Total Disability to Standard Life Insurance within twelve months from the date the disability begins.
If acceptable written proof is not received within this twelve-month period, any life insurance continued under this Waiver of Premium provision will terminate at the end of the twelve-month period.
The amount of life insurance that will be continued under the Waiver of Premium provision will be the amount of insurance in force for you on the date disability begins, subject to any reduction or termination in the amount of insurance due to reaching specific age(s) or retirement.
Life Insurance and AD&D Benefits Appeals
If a claim for life insurance or AD&D benefits insured by Standard Life Insurance is denied in whole or in part by Standard Life Insurance, you will be notified in writing within ninety days of receipt of your claim. In special circumstances, an additional ninety days may be required for consideration of your claim. If additional time or information is needed, you will be notified in writing of the reasons before the first 90-day period expires. In no case will the extension exceed one-hundred-eighty days from the date your claim was received by Standard Life Insurance.
The notice of decision on your claim will contain specific reasons for the decision and a specific reference to the provisions of the Plan or policy on which the decision is based. The notice will also describe any additional information you must provide to perfect your claim and explain why this information is necessary. You will have forty-five days to submit this additional information to Standard Life Insurance.
An employee or dependent whose claim has been denied in whole or in part by Standard Life Insurance may appeal the decision to the Appeals Committee of the Board of Trustees of the Fund. An appeal to the Appeals Committee must be in writing, submitted to the Chief Executive Officer of the Fund within sixty (60) days of the initial denial of the claim, accompanied by a statement giving the reasons the denial is believed to be incorrect. You will be given full access by Standard Life Insurance to all documents or other information that relates to your claim for this purpose.
A decision by the Appeals Committee shall be made within sixty days after the receipt of the appeal. An additional sixty days may be required under special circumstances. If additional time or information is needed, you will be notified in writing of the reasons before the first 60-day period expires. In no case will the extension exceed one hundred twenty days from the date your appeal was received. The notice of the decision will contain specific reasons for the decision and a specific reference to the provisions of the Plan or policy on which the decision is based.
The decision of the Appeals Committee on your claim is final. If you disagree with the decision, you have the right to bring a legal action against the Fund and its Trustees in Federal Court.
See more information on your rights under the Employee Retirement Income Security Act.