- When do I become eligible for benefits?
- How many hours a month do I have to work to maintain eligibility for benefits?
- What if I do not work the Required Hours for medical coverage?
- How do I enroll in COBRA Continuation Coverage?
- How long will my benefits be in effect after my employment terminates?
- What is a “break in service”?
- Will I lose eligibility if I have a break in service?
Platinum Plus Plan Participants
Plan A employees hired prior to March 1, 2004 or Plan B employees hired prior to October 4, 2004 who meet the Platinum Plus “continuing eligibility” requirements are eligible for Platinum Plus benefits. “Continuing eligibility” is earned on a “skip-month” basis. You are eligible for benefits during the second month following the month in which you earn the Required Hours
Silver/Gold/Platinum Plan Participants
Plan A employees hired on or after March 1, 2004 and Plan B employees hired on or after October 4, 2004 (except Clerks Helpers/Utility Clerks) become eligible to elect coverage in the plan beginning the first day of the calendar month following their sixth month of employment. Premiums must be paid and the Required Hours worked in the fifth month for initial coverage in the seventh month.
Plan A Clerks Helpers hired on or after March 1, 2004 and Plan B Utility Clerks hired on or after October 4, 2004 become eligible to elect employee-only coverage beginning the first day of the calendar month following their 18th month of employment. Premiums must be paid and the Required Hours worked in the 17th month for initial coverage in the 19th month. If you are promoted, credit is given for the purpose of medical plan eligibility and dependent coverage from your original date of hire.
You must work the following Required Hours each month to maintain your eligibility for continuing medical coverage:
|All Clerks Helpers and Utility Clerks||64 hours|
|Plan B Clerks, Plan A and B Meat Cutters, and Uniform Department Employees||76 hours|
|Plan A Food and Meat Clerks and General Merchandise Clerks||92 hours|
The hours you work in any one week are credited to you as of each Sunday, based on the standard industry workweek, which is Monday through Sunday. Your monthly hours are credited to you as of the last Sunday of each month.
If you do not work the Required Hours, you will lose your eligibility for medical coverage. (Note: Your eligibility may terminate for reasons other than a lack of Required Hours, for example, due to termination or lay-off.)
If your eligibility ceases because you failed to earn the Required Hours, or due to termination or lay-off, you may elect COBRA Continuation Coverage. You will receive a COBRA notice and Loss of Eligibility letter. If you were on vacation, complete the applicable portion of the form and return to it to the Fund. If you are on approved family leave, complete the applicable portion of the form and attach a copy of the approval letter from your employer.
Platinum and Platinum Plus participants may use state disability check stubs to extend their eligibility for benefits for six months or Workers Compensation check stubs to extend eligibility for 12 months. If you were on state disability or Worker’s Compensation, complete the applicable part of the form and submit with proof of payment from the state or the insurance carrier.
Plan A and B Silver and Gold participants cannot extend their benefits, but should submit proof of payment for state disability or Workers Compensation to preserve their months of employment to maintain skip month eligibility when they return.
To elect COBRA Continuation Coverage, complete and return the election form within 60 days of loss of coverage.
COBRA Continuation coverage requires a monthly premium. COBRA premium rates are based on the type of coverage elected and the number of persons enrolled. The first payment must be received within 45 days from your election date. Subsequent payments are due on or prior to the first of the coverage month and will not be accepted after the last day of the month.
Failure to make a payment timely terminates eligibility for COBRA Continuation Coverage.
Coverage terminates on the last day of the month in which your employment ends. You will be sent a COBRA notice and a Loss of Coverage letter. To elect COBRA coverage, follow the instructions noted above. Please keep the Loss of Coverage letter for your records.
Employees experience a break in service when no hours are reported for a period of four months or longer.
- What are the risks of not enrolling when I am eligible?
- Which family members can I cover?
- How do I enroll?
- How can my child extend his/her coverage after reaching age 19?
- How do I enroll my registered domestic partner or same sex spouse?
- What documentation do I need to provide for my marriage, divorce, domestic partnership, or death?
- How long do I have to submit a birth certificate?
- What are my choices for medical coverage?
- When can I change my coverage election?
In general, if you choose not to enroll in medical coverage when you become eligible and/or during the annual Open Enrollment period, you may not elect to participate in the plan until the next year’s Open Enrollment (typically in January of each year).
Note: There are some exceptions to this rule. If you decline participation because you have group health plan coverage through another source (e.g., your spouse’s employer’s plan) and lose that coverage during the year, you may elect to participate in the Trust Fund’s plan if you meet the eligibility requirements. You must contact the Fund Office within 120 days of the loss of coverage to enroll in the Fund’s plan. In addition, if you experience a mid-year change of status event (e.g., you have a baby or are divorced), you may be eligible to make related changes to your coverage election. Contact the Fund Office for more information.
Silver, Gold and Platinum clerks may choose to cover their eligible dependents. Dependent children are eligible to participate in the plan on the first day of the month following the employee’s sixth month of employment. The employee’s spouse/registered domestic partner is eligible on the first day of the month following the employee’s 24th month of employment.
Coverage for dependent children and the spouse of a Platinum Plus participant is automatic. Required documentation must be received within 120 days of birth or marriage.
Eligible dependents include the following individuals:
- Your legally married spouse
- A domestic partner with whom you have filed a Certificate of Registration of Domestic Partnership with the California Secretary of State
- Your unmarried natural or legally adopted children (including children placed for adoption) under 19 years of age (unmarried stepchildren, children of your registered domestic partner, and foster children can be covered if they depend on you for support and they meet the Fund’s other eligibility requirements)
- Your unmarried children 19 through 23 years of age if they are full-time students
- An unmarried child of any age who is unemployable because of permanent mental or physical disability that began prior to age 19 or between the ages of 19 and 24 while covered as a dependent student in an accredited educational institution
- A child you are required to cover under a Qualified Medical Support Order
Note: Clerks Helpers/Utility Clerks do not have the option to cover their dependents. However, Clerk’s Helpers/Utility Clerks promoted to Clerk will become eligible to elect dependent coverage when promoted, if their promotion follows their sixth month of employment. For more information, call your local or the Fund Office.
You must provide proof of your relationship.
To enroll in medical coverage, complete an Enrollment Form and Payroll Deduction Authorization Form and return it to the Fund Office by the deadline noted in your enrollment materials.
Students may be eligible for coverage from age 19 through their 24th birthday month as long as they are unmarried and a full-time student at an accredited school. A completed “Student Certification,” signed by the member and School Registrar, must be on file for each school term. To cover the summer months, the member must complete and sign a “Student Certification of Intent to Return to School After Summer Recess” each year.
The Fund Office must be notified if the student drops below a full-time course load during the semester.
Overage dependents may elect COBRA Continuation Coverage if they are between the ages of 19 and 24 and are not full-time students or after they reach the age of 24 and are no longer eligible to extend their coverage as a full-time student.
If you wish to enroll your registered domestic partner or same sex spouse and his/her children, you will need to complete and return specific paperwork to the Fund Office.
You will also be required to pay taxes on the value of the coverage provided to your registered domestic partner or same sex spouse and their children unless they qualify as your tax dependents under the Internal Revenue Code.
Contact the Fund Office for a complete information package on registered domestic partner or same sex spouse coverage, which will include specific tax information and all necessary paperwork for enrolling your registered domestic partner or same sex spouse and/or his/her children in the plan.
The Trust Fund’s medical plans coordinate with other employers’ health care plans to ensure that those plans share some of the cost of benefits for working families. The Fund’s plans require that if your working spouse or registered domestic partner is eligible for other health care coverage through his/her own employment, he/she must enroll in the best plans offered through that employer, even if those plans require payment of a premium by the spouse or registered domestic partner.
If your working spouse or registered domestic partner does not enroll for all health care benefits available through his/her employer, he/she will not receive full benefits under the Trust Fund’s plans. Contact the Fund Office if you have questions.
If your spouse or registered domestic partner’s employer offers a choice of plans, benefits under the Fund’s plans will be paid assuming that your spouse or registered domestic partner is enrolled in the best plan available from his or her employer.
If your spouse or registered domestic partner is not working now but becomes eligible for coverage through employment in the future, he/she must enroll in the available coverage at the earliest opportunity.
This rule does not affect coverage for your eligible dependent children. Only your spouse or registered domestic partner is required to enroll in other coverage that is available to him/her.
Copies of your recorded marriage certificate, domestic partner registration, divorce, and birth certificate are required to enroll your dependents in coverage and/or to make coverage election changes in support of these life events during the plan year. (Only Clerks may enroll their dependents in coverage.)
If you request enrollment within 120 days, your spouse/registered domestic partner’s or dependent child’s coverage will be retroactive to the date you gained your new dependent (provided you were eligible at the time). If you request enrollment after 120 days following the event, and no later than the end of that year’s Open Enrollment period, your dependent’s coverage will take effect the first day of the month after the Fund Office receives your enrollment forms.
In the event you have a baby, be sure to submit a copy of the hospital birth certificate to the Fund Office as soon as possible following the baby’s birth. This will ensure the baby’s coverage is in effect retroactive to his or her birth date. Then, be sure to provide a copy of the recorded birth certificate to the Fund Office within 120 days of the baby’s birth date.
Plan A employees hired prior to March 1, 2004 and Plan B employees hired prior to October 4, 2004 (Platinum Plus) may enroll in one of the following plans:
- The Indemnity PPO Medical Plan with a Health Reimbursement Account (HRA)
- Kaiser HMO
- PacifiCare HMO
Plan A employees hired on or after March 1, 2004 and Plan B employees hired on or after October 4, 2004 (Silver/Gold/Platinum) may enroll in the Indemnity PPO Medical Plan with a Health Reimbursement Account (HRA). Payment of a weekly premium is required for this coverage. HMO plans are not available to these groups.
Plan A and Plan B Platinum Plus participants may change their medical coverage election yearly at Open Enrollment. A plan change can also be made once in a 5-year period outside of Open Enrollment.
Outside of Open Enrollment, if you are enrolled in medical coverage and are eligible to elect coverage for your dependents, you can add coverage in the event you acquire a new spouse/registered domestic partner or dependent child.
Also, if you decline enrollment for yourself and/or your eligible dependents because you and/or they have other group health insurance, you may be able to enroll outside of Open Enrollment, provided that you request enrollment within 120 days after the loss of the other group coverage.
Contact the Fund Office for more information regarding changes to your medical coverage election outside of the annual Open Enrollment period.
Plan A employees hired on or after March 1, 2004 and Plan B employees hired on or after October 4, 2004 pay the following premiums for coverage. This amount will be deducted automatically from your paycheck on a weekly basis.
- If you choose to enroll in Employee-Only coverage, your premium is $7.00 per week.
- If you are a Clerk and choose to enroll your children, the premium for you and your children is $10.50 per week.
- If you are Clerk with at least 24 months of service and choose to enroll your legal spouse or registered domestic partner, the total premium for you and your spouse/registered domestic partner or your spouse/registered domestic partner and any dependent children is $15.00 per week (your payment is the same whether or not you have dependent children).
You must complete a Payroll Authorization form to permit your employer to withhold the amount of your premium payment from your paychecks.
Currently, employees hired prior to March 1, 2004, do not pay premiums for coverage.
Automatic payroll deductions for your plan elections are required. To set up your deduction, complete an Enrollment Form and Payroll Deduction Authorization Form and return it to the Fund Office by the deadline noted in your enrollment materials.
When you visit an Anthem Blue Cross network provider (or HMO provider for Platinum Plus members), in most cases, the provider will take care of the claims process—no claim forms are required.
If you visit a non-network provider, or if your provider will not file a claim on your behalf, you will have to pay that provider up front and submit a claim to the Fund Office for reimbursement of the covered amount. You can request claim forms from the Fund Office.
You may request a free copy of the claims and appeals procedures from the Fund Office or local union office.
Within 180 days after you receive the explanation of benefit, you, or your authorized representative, may file a written appeal with the Fund Office if you dispute the determination. You may request, free of charge, relevant documents, records or other information from the plan and the identity of medical experts, if any, who advised the plan about the claim. You may submit written comments, documents, records and other information to support you appeal.
The Appeals Committee will review your appeal at its first meeting that is at least 30 days after your appeal is filed. You will be notified if an extension is necessary and the date by which a decision will be made. A decision may be delayed to allow you to submit additional information. You will be notified of the decision within five days after it is made. If your appeal is denied, in whole or part, you may file a civil action under ERISA Section 502(a).
“HRA” stands for “Health Reimbursement Account.” A Health Reimbursement Account is an arrangement through which the Fund reimburses you for eligible health care expenses, such as deductibles, coinsurance or reimburses you for prescription drug copays. The HRA is offered as a part of the Indemnity PPO Medical Plan, providing you and your family members with funding each year to pay for your eligible medical and other health care expenses. Any unused balance in your HRA at year-end rolls over for use in the next plan year.
The Fund administers the HRA on your behalf. You may contact the Fund Office, or refer to the HRA/HRQ section of this web site, for additional information regarding the HRA.
“HRQ” stands for “Health Risk Questionnaire.” A Health Risk Questionnaire is a confidential survey/questionnaire prepared by health care experts provided to you each year to help identify and seek early care and treatment for potential health risks. The questionnaire includes basic questions about health history, your lifestyle and family history. It also includes questions that help to specifically address health issues for men and for women individually. The results of the HRQ are provided only to the individual who completes the HRQ—your employer, the Fund Office, and your union will NOT receive this confidential information.
As a follow-up to the questionnaire, you will receive confidential feedback from the HRQ vendor on health areas where you might be at risk (for example, potential issues with heart disease, high blood pressure, or diabetes). In addition, if you complete the questionnaire, you will receive additional funding for your HRA, for use in paying your eligible health care expenses during the year.
Refer to the HRA/HRQ section of this web site, for additional information regarding the HRQ.
- What is a deductible?
- What is coinsurance?
- What is an annual out-of-pocket maximum?
- I need surgery; what should I be aware of?
- I am enrolled in the Indemnity PPO Medical Plan, and I want to use a doctor who is not part of the Anthem Blue Cross provider network. What should I be aware of?
- I am enrolled in the Indemnity PPO Medical Plan; how do I find a doctor in the Anthem Blue Cross provider network?
- How do I request a medical plan identification card?
- How do I contact my medical plan carrier?
Under the Indemnity PPO Medical Plan, a deductible is a specific amount of expense that you pay before the plan begins to pay its benefits. You may satisfy the deductible with a combination of expenses. The funds available in your HRA may be used to help satisfy your deductible. Once you satisfy the deductible, the plan’s coinsurance benefits kick in.
Under the Indemnity PPO Medical Plan, coinsurance is the amount you pay for the medical services you receive. It is not a set amount and will vary based on the cost of the procedures, although the percentage the plan pays and you pay remains the same. For example, under the Silver plan, the plan’s coinsurance for an in-network doctor’s visit is 75% of negotiated fees; you pay the remaining balance. Coinsurance does not count toward satisfaction of the deductible.
The annual coinsurance out-of-pocket maximum is a limit on the amount you pay out of your pocket for covered services in a calendar year. It is lower for services received in the Anthem Blue Cross provider network than for services received outside of the network. If your share of covered charges exceeds the plan’s out-of-pocket maximum, the plan will pay 100% of your covered charges for the remainder of the calendar year, except for your required copays. The deductible does not apply toward your annual out-of-pocket maximum.
Indemnity PPO Medical Plan participants should contact Anthem Blue Cross prior to surgery to ensure prior authorization of the surgery and related procedures and hospitalization. While prior authorization is not required, it is good practice to discuss surgical procedures with both your doctor and your medical plan carrier to help to ensure you understand benefits, risks and costs of surgery. Be sure to consider and ask your doctor and Anthem Blue Cross these questions:
- What surgical procedure are you recommending?
- Why do I need the surgical procedure?
- Are there alternatives to surgery?
- What are the benefits of having the surgical procedure?
- What are the risks of having the surgical procedure?
- What will happen if I don’t have this surgical procedure?
- Where can I get a second opinion?
- What has been your experience in doing the surgical procedure?
- How many have you performed?
- Where will the surgical procedure be done?
- What kind of anesthesia will I need?
- How long will it take me to recover?
- How much will the surgical procedure cost?
Visit the Anthem Blue Cross website at www.anthem.com/ca/ to search for a PPO provider. You can also request a directory from the Fund Office or your union local. Make sure you verify your doctor is still part of the Anthem Blue Cross network when you make your appointment.
Benefits are covered at lower levels when you use an out-of-network provider. This means you can expect to pay more out of your pocket.
When you visit a health care provider, you will need to present your medical plan ID card at the time you seek care. You should receive your ID card after you enroll. To request a replacement card, or if you do not receive your ID card in the mail, contact the Fund Office (if you are enrolled in the Indemnity PPO Medical Plan) or your HMO directly (if you are enrolled in the Kaiser or PacifiCare HMO).
The best way to contact your medical plan carrier is through its toll free customer service number or web site. Contact information is as follows:
Anthem Blue Cross
- What type of Pension Plan does the Fund offer?
- What is ERISA?
- Once I’m in my fifth vesting year, do I have to wait until the end of the year to be vested?
- When will I reach the Rule of 85?
- What happens if I’m vested but I die before retirement?
- Can I get my pension in one lump sum?
- Do Security Benefits affect my pension from the Plan?
- Do my union dues pay for my pension benefits?
- How long will it take to process my retirement application?
- Once I retire, will I get automatic cost-of-living increases?
- When are pension checks mailed?
- Is electronic deposit of my pension check available?
- Can my creditors put a lien against or garnish my pension benefit?
- I was awarded a part of my ex-spouse’s pension. Do I get the pension automatically or do I need to apply?
- Why is Pension Payment Verification required after retirement?
The Southern California United Food & Commercial Workers Unions and Food Employers Joint Pension Trust is a multi-employer defined benefit pension plan that pays benefits in the form of a monthly annuity to eligible participants.
ERISA is an acronym for the Employee Retirement Income Security Act of 1974 (ERISA), a federal law that sets minimum standards for pension plans in private industry. For example, if an employer maintains a pension plan, ERISA specifies:
- When an employee must be allowed to become a participant
- How long the employee has to work before he/she has a non-forfeitable (vested) interest in his/her pension
- How long an employee can be away from his/her job before his/her benefit is affected
- Whether his/her spouse has a right to part of the pension benefit in the event of the employee’s death
ERISA does not require any employer to establish a pension plan. It only requires that those who establish plans must meet certain minimum standards. The law generally does not specify how much money a participant must be paid as a benefit.
You don't have to wait to the end of the calendar year. You are vested when you complete your 150th hour of service in your fifth vesting year.
If you were hired by an employer prior to March 1, 2004, you will qualify for the Rule of 85 when your age (in years and full months) plus years of benefit credit total 85. For example:
+ 31.25 Years of Benefit Credit
= 85.00 Total
If you are planning to retire with the Rule of 85, do not quit your job until you confirm your credits with the Fund Office.
Years of benefit credit that are counted toward the Rule of 85 may include up to ten years of reciprocal service and up to ten years of employment due to an involuntary transfer with the same employer, which occurred between January 1, 1995 and December 31, 1998 to a location and job classification which was represented by a union other than a UFCW Union and not covered by this plan.
If you and your spouse were married at least one year prior to your death, your spouse may receive a surviving spouse pension benefit on the later of either the 1st of the month following your death, or the 1st of the month following the date you became eligible for an Early Retirement benefit. If you are not married but have children under the age of 18, your children may receive a surviving child benefit up to the age of 18. Other plan rules may also apply.
No, unless the actuarial value of your monthly pension benefit is $5,000 or less as of your date of retirement. If the value of your pension benefit is more than $5,000, you cannot receive a lump sum payoff of your benefit. The Fund Office will determine whether you are eligible for a lump sum pension when processing your retirement and will automatically issue you a lump sum payment if you are eligible for it.
No. Benefits under the plan are in addition to your Social Security benefits.
No. Only employer contributions and investment earnings pay for plan benefits.
Processing time is generally eight to ten weeks.
No. The benefits provided by this Pension Fund result from collective bargaining between contributing employers and unions, and can only be changed by the collective bargaining parties. Your pension benefit is calculated at the benefit level in effect when you last worked in the industry and is based on your years of service.
Pension checks are mailed two business days before the first of the month.
Yes, retirees and beneficiaries may have their pension payments directly deposited to their checking or savings accounts. You can arrange for this when you apply for retirement or at any time after you retire. Generally, it takes two months to set up your electronic deposit. Your pension is then electronically transmitted the third month following the Fund Office’s receipt of your authorization form. Until then, your pension check is sent to your mailing address on record.
No. Your pension is generally protected by ERISA’s anti-alienation provisions. However, pension benefits can be reduced through Qualified Domestic Relations Orders and federal tax liens.
You must send copies of any court documents related to your ex-spouse's pension to the Pension Fund Office immediately. Plan representatives can verify whether the documents are in compliance with federal law and plan rules, and whether you need to take further action.
The Trustees of the Southern California United Food and Commercial Workers Unions and Food Employers Pension Trust Fund require that every Retiree complete a Pension Payment Verification form each year verifying that they are alive and are receiving the benefits to which they are entitled.
The Pension Plan states:
“Section 12.04 Information to be Furnished. Each participant or any other claimant shall furnish to the Board any information or proof requested by it and reasonably required to administer the Plan. Failure on the part of any Participant or claimant to comply with such request completely and in good faith shall be sufficient grounds for denying, suspending or discontinuing benefits to such person. If a Participant or other claimant makes a false statement material to his claim, the Board shall recoup, offset or recover the amount of any payments made in reliance on such false statement in excess of the amount to which such Participant or other claimant was rightfully entitled under the provisions of this Plan.”
|UFCW Scholarship Award Program|
- Who is eligible for scholarship awards?
- What are the amounts of the scholarship?
- What is the deadline for submission of an application for the scholarship?
- When are the scholarships awarded?
- Who determines the award recipients?
- What does the scholarship award cover?
- What forms and documents are required for the scholarship award?
Employees covered under Plan A/A110 are eligible as follows:
- Participants who have completed at least one year of service as of the prior October. Participants must be actively employed when the awards are determined. Spouses of participants are not eligible.
- Dependent children if the participant has completed at least three years of service as of the prior October provided they are unmarried and less than 24 years of age.
- Awards are made to full-time students seeking undergraduate college degrees or post-high school technical or vocational training. The school must be accredited or licensed by the State.
Scholarships are available in the following amounts:
All applications and accompanying documentation must be postmarked no later than February 28, or the last day of February.
Awards are generally made by April 30 of each year.
Awards are determined by a Scholarship Selection Committee jointly selected by the Union and Employer Trustees.
Scholarships cover tuition fees only and cannot be used for housing expenses, books or other incidental fees. Scholarships are paid directly to the school.
The following forms and documentation are required:
- Scholarship Application Form – completed and signed by participant and applicant (student)
- Answers to questions 4 – 9 at the back of the application form
- Official transcript showing cumulative GPA and SAT scores; attach a copy of SAT scores if not shown on transcript
- Two Teachers Appraisal Forms with attached letters of recommendation
A copy of FAFSA or SAR (Student Aid Report); the Fund needs information on household income and number of persons and college students in the household.
- Who is eligible for tuition assistance?
- What are the amounts of the tuition assistance?
- What is the deadline for submission of an application for tuition assistance?
- What forms and documents are required to apply for tuition assistance?
Employees covered under Plan A/A110 are eligible for tuition assistance as follows:
- Participants who have completed at least a year of service prior to the beginning of the classes and who are actively employed during the month these classes begin. Spouses of participants are not eligible.
- Dependent children if the participant has attained at least ten years of vesting credit provided the children are unmarried and less than 24 years of age.
Tuition assistance is offered in the following amounts:
- $500 per calendar year for participants
- $300 per calendar year for dependent children
All applications and accompanying documentation must be received by the Fund within one year after the participant or child has completed the applicable course or courses.
The following forms and documentation are required:
- Tuition Assistance Application Form (for participant or for child of participant) completed and signed by the participant
- Proof of payment (i.e. receipt, payment history, student account summary)
- Proof of successful completion of courses (i.e. transcript, copy of final grades, certificate of completion)