United Food & Commercial Workers

Unions and Employers

Midwest Health and Pension Funds

UFCW Calumet Region Insurance Fund

Appeal of Denial of Benefits

If you believe you have been improperly denied benefits, you are entitled to a full and fair review of your claim.

If your claim is denied, you will be given a written explanation that will provide:

  • the specific reason or reasons for the denial, including a reference to the specific Plan provisions on which the denial is based;
  • a description of any additional material or information required for you to show you are entitled to benefits;
  • an explanation of the procedure to be followed if you do not agree with the denial;
  • notice of your right to bring a civil action under ERISA following an adverse determination on review; and
  • in the case of a disability pension claim, notice if the Plan relied on an internal rule, guideline, protocol or other similar criteria and notice of your right to receive a copy of such document free of charge upon request.

File an Appeal

If you do not agree with the claim denial decision, you may file an appeal with the Board of Trustees. You must file your appeal within 180 days after you receive the denial of your initial claim. To file an appeal, send a written statement that indicates you are appealing the denial and that includes your reasons for appealing the decision and any supporting documents not previously furnished. Send your appeal to:

Board of Trustees
United Food and Commercial Workers
Unions and Employers Midwest Pension Fund
18861 90th Avenue, Suite A
Mokena, IL  60448-8178

 
You will receive a written decision concerning your appeal after it is reviewed by the Trustees. The Trustees meet quarterly to review the appeals the Plan receives following their last meeting (except that any appeal filed within the 30-day period preceding a meeting will be decided at the next following quarterly meeting). The appeal decision can be delayed until the third quarterly meeting following receipt of an appeal if special circumstances require a delay; the Plan will contact you if your appeal will be delayed. The Plan will notify you of the Trustees’ decision within 5 days after they make their decision. The written decision will include:

  • the specific reason or reasons for the decision, including a reference to the specific Plan provision(s) on which the decision is based;
  • notice of your right to access and copy information relevant to your claim;
  • notice of your right to bring a civil action in federal court; and
  • in the case of a disability claim, notice if the Plan relied on an internal rule, guideline, protocol or other similar criteria and notice of your right to a copy of such document free of charge upon request.

  

(Updated 09/26/13)