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SUMMARY
PLAN DESCRIPTION
SUMMARY OF THE TEAMSTERS MISCELLANEOUS
SECURITY TRUST FUND HEALTH AND WELFARE PLAN
FOR ACTIVE AND RETIRED EMPLOYEES
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Name of Plan:
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This
Plan is known as
Teamsters
Miscellaneous Security Trust Fund |
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Name, Address and Telephone Number of Plan Sponsor and Administrator:
This Plan is sponsored by a joint labor-management Board of Trustees, the name, address and telephone number of which
is:
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Board of Trustees of the
Teamsters Miscellaneous Security Fund
1000 South Fremont Avenue,
Unit 11
Alhambra, California 91803
(877) 350-4792 or (626) 284-4792
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Name, Title and Principal Place of Business of Each Trustee:
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EMPLOYER TRUSTEES
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E. Carl Sarjeant
1485 Pomona Rd. Suite
D
Corona, California
92880
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Nick Silk
ADVANCE PAPER BOX
COMPANY
6100 South Gramercy
Place
Los Angeles,
California 90047
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Neil O'Dwyer
Department 4
1000 South
Fremont, Unit 11
Alhambra,
California 91803 |
Felix Serna
Department 4
1000 South Fremont,
Unit 11
Alhambra, California
91803
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UNION TRUSTEES
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Robert Lennox
TEAMSTERS LOCAL 495
9101 East Whittier Boulevard, 2nd Floor
Pico Rivera, California 90660
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Michael J. Riley
TEAMSTERS LOCAL 986
Department 4
1000 South
Fremont, Unit 11
Alhambra,
California 91803 |
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Chris Griswold
TEAMSTERS LOCAL 986
1198 Durfee
Avenue
South El Monte,
California 91803 |
Mike Bergen
TEAMSTERS LOCAL 166
18597 Valley Boulevard
Bloomington, California
92316-0899 |
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Identification Numbers:
The employer identification number assigned to the Board of Trustees
by the Internal Revenue Service is EIN 95-6060502.
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Type of Plan:
The Plan is a Health and Welfare Plan which provides Death,
Hospital, Surgical, Medical, Dental, Prescription and Vision benefits for
eligible active and retired employees and their eligible
dependents.
The Hospital, Surgical and Medical Plan offers the choice of
either the Medical Reimbursement Plan (Indemnity),
Kaiser, Health Net or
PacifiCare. Information on the different plans can be obtained from
Southwest
Administrators at (877) 350-4792 or (626) 284-4792.
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Source of Contributions:
Employers and Unions
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Entities Used for Accumulation of Assets and Payment of Benefits:
The employer contributions are received and held in trust by the
Board of Trustees which underwrites and provides the benefits.
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Plan Year:
The Plans is on a fiscal year basis. The end of the Plan Year is May 31.
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Statement of ERISA
Rights:
As a participant in the Teamsters Miscellaneous Security Trust Fund, you are entitled to certain rights and protections under the
Employee Retirement Income Security
Act of 1974 (ERISA). ERISA provides that all plan participants shall be entitled to:
Receive Information About Your Plan and Benefits:
Examine, without charge, at the plan administrator's office and at other specified locations, such as worksites and union halls, all documents governing the plan, including insurance contracts and collective bargaining agreements, and a copy of the latest annual report (Form 5500 series) filed by the plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Pension and Welfare Benefit Administration.
Obtain, upon written request to the plan
administrator, copies of documents governing the operation of the plan, including insurance contracts and collective bargaining agreements and copies of the latest annual report (Form 5500 series) and updated summary plan description. The Administrator may make a reasonable charge for the copies.
Receive a summary of the plan's annual financial report. The plan administrator is required by law to furnish each participant with a copy of this summary annual report.
Continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the plan as a result of a qualifying event. You or your dependents may have to pay for such coverage. Review this summary plan description and the documents governing the plan on the rules governing your
COBRA continuation coverage rights.
Reduction or elimination of exclusionary periods of coverage for pre-existing conditions under your group health plan, if you have creditable coverage from another plan. You should be provided a certificate of creditable coverage, free of charge, from your group health plan or health insurance issuer when you lose coverage under the plan, when you become entitled to elect COBRA continuation coverage, when your COBRA continuation coverage ceases, if you request it before losing coverage, or if you request it up to 24 months after losing coverage. Without evidence of creditable coverage, you may be subject to a pre-existing condition exclusion for 12 months (18 months for late enrollees) after your enrollment date in your coverage.
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Prudent Actions by Plan Fiduciaries:
In addition to creating rights for plan participants ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your plan, called "fiduciaries" of the plan, have to do so prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a (pension, welfare) benefit or exercising your rights under
ERISA.
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Assistance With Your Questions:
If you have any questions about your plan, you should contact the
plan
administrator. If you have any questions about this statement or about your rights under
ERISA, or if you need assistance in obtaining documents from the plan administrator, you should contact the nearest office of the Pension and Welfare Benefits Administration, U. S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U. S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under
ERISA by calling the publication hotline of the Pension and Welfare Benefits Administration.
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Type of Administration:
The plan is administered by the Board of Trustees with the
assistance of various contract administrative organizations which operate the
Trust's Administrative Office. For general information about the plan, contact
the Administrative Office.
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| Name and Address of Agent for Service of Legal Process:
The person designated as the Plan's agent for service of legal process is:
SOUTHWEST ADMINISTRATORS
1000 South Fremont Avenue,
Unit 11
Alhambra, California 91803
In addition, service of legal process on the plan may be effected by service of process on the
Board of Trustees at the Trust Office or on any Trustee at his address. |
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Maintaining the Plan Pursuant to Collective Bargaining Agreements:
The plan is contributed to by Local Unions, subscribing employers and employers who are parties to collective bargaining agreements requiring contributions to the Trust. These agreements generally provide that the employers who are parties thereto will make monthly contributions to the Teamsters Miscellaneous Security Trust Fund for the purpose of enabling eligible
employees to participate in the Teamsters Miscellaneous Security Trust Fund. The
contribution rates and the job classifications covered are specified in such agreements. The plan is funded by these
contributions. A list of employers and unions maintaining the plan and a copy of each of these subscribing agreements and collective bargaining agreements is available for examination, without charge by participants and beneficiaries at the Trust's Administrative Offices. A copy of any of these documents may be obtained by participants and beneficiaries upon written request
addressed to:
TEAMSTERS MISCELLANEOUS SECURITY TRUST FUND
1000 South Fremont Avenue,
Unit 11
Alhambra, California 91803
The Trustees will make a reasonable charge for providing copies of any documents so requested.
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APPEAL PROCEDURES:
The remedies available under the plan for the redress of claims which are denied in whole or in part are set forth below:
Appeals to the Board of Trustees:
Any participating employee or beneficiary of a participating employee who applies for benefits under the plan and is ruled ineligible by the Trustees (or by an administrative agent, insurance carrier or other organization acting for the Trustees) or who has reason to believe he did not receive the full amount of benefits to which he is entitled, or who is otherwise adversely affected by any action of the Trustees, may request a review of that matter by the Trustees, or a Review Committee established by the Trustees for that purpose, provided that the claimant submits such a request, in writing, to the Trust's Administrative Offices, within 60 days after being apprised of, or learning of, the action complained of.
The Administrative Office will give the claimant an opportunity to review pertinent documents (other than documents that are subject to legal privilege) in preparing his request for review. The request must set forth all the grounds upon which it is based, supporting facts and any other matters which the claimant deems pertinent.
The Trustees or Review Committee shall act upon a request for review within 60 days after receipt thereof unless special circumstances require further time, but in no event later than 120 days after receipt. If the Trustees or Review Committee confirm the denial in whole or in part, the Administrative Office will give written notice to the claimant the specific reasons for a denial and specific references to the plan provisions on which the decision is based.
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Enforce Your Rights:
If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.
Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest annual report from the plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the plan administrator to provide the materials and pay you up to $110.00 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a State or Federal court. In addition, if you disagree with the plan's decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in Federal court.
If it should happen that plan fiduciaries misuse the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U. S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.
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