United Food & Commercial Workers

Unions and Employers

Midwest Health and Pension Funds

UFCW Calumet Region Insurance Fund

Pension Plan Application Procedures—Standard and Disability Applications

This contains information regarding pension application and appeal procedures and is effective January 1, 2002. It addresses how to apply, gives detailed time frames that the Fund Office follows while considering your application, and describes what to do if your application is denied. Answers to specific questions regarding eligibility requirements and other pension-related issues can be found in the Plan document, a plan booklet (Summary Plan Description), and/or on the pages of this website. The guidelines contained in this document apply to applications filed after January 1, 2002.

Requests for application forms may be made by contacting the Fund Office.

Types of Applications

For purposes of these guidelines, there are two types of pension applications: standard and disability. There are different requirements and different procedures for each type of application.

Standard Applications—those filed by employees who are at least 54 years of age. A standard application is considered complete when a request for benefits to begin on a specific date is received. Standard applications also include those filed by survivors of participants who die prior to retirement.

Disability Applications—those filed by employee-members of any age who are presumably totally and permanently disabled. To be considered complete, an application for a Disability Pension must include a copy of an award or denial letter from the Social Security Administration. However, an applicant is encouraged to file the application even if the Social Security Administration’s award or denial response has not yet been received.

Initial Approval or Denial

Standard Applications. The Fund Office will make a determination regarding an applicant’s eligibility for benefits no more than 90 days after receipt of a complete application. If there are special circumstances which require additional time to process an application, the Fund Administrator will provide an extension notice to the applicant. This notice will be made prior to the end of the initial 90 day period, and will indicate a date as of which the Fund Office expects to reach the determination.

Disability Applications. The Fund Office will notify a disability applicant if an application is wholly or partially denied within 45 days from receipt of the complete application. Again, a disability application is considered complete once a Social Security Administration award or denial letter has been received. This 45 day period may be extended by the Fund Administrator if it is determined that, due to matters beyond the Fund’s control, additional time is needed to make a determination. This extension may be up to 30 days. The Fund Administrator will provide an extension notice to the applicant that will indicate the reason for the extension and the date the Fund expects to reach a decision. If, prior to the end of the 30-day extension the Fund Administrator determines that, due to reasons beyond the Fund’s control, a decision cannot be given within the extension period, the decision period can be extended another 30 days. All extension notices will include the standards on which entitlement to the benefit is based, the unresolved issue that prevents a decision on an application, and any additional information needed to resolve the issue. The applicant will be given at least 45 days to provide the required information.

Right to Appeal

An applicant has certain rights to appeal a denial of benefits.

Applicants have 60 days from receipt of the notice of benefit denial to file an appeal. The Board of Trustees will review the appeal at their next quarterly meeting, unless the appeal is filed less than 30 days prior to the date of the next meeting. In such cases, the appeal will be considered no later than the date of the second meeting following receipt of the appeal request. If special circumstances require a further extension, the Board can make the decision no later than the third meeting. Notice of the Board’s decision will be provided no later than five days after the decision is made.

Right to File a Lawsuit

An applicant has the right to bring a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974 (ERISA) following denial of an application on appeal.

Authorized Representative

An applicant, or his or her legal guardian, may authorize another individual to act on his or her behalf. This authorization must be made in writing, on a form provided by the Fund Office. Once authorized, this representative may make inquiries and file appeals on behalf of the applicant, and all written correspondence will be addressed to the representative unless the Fund Office is directed otherwise by the applicant.

  

(Updated 05/01/13)