FRAUD & MISREPRESENTATION

CAN I VOLUNTARILY PARTICIPATE IN A HIGHER BENEFIT LEVEL?

Members in good standing who have zero dollars ($0.00) or have below the required level for Health and Welfare account balances and who wish to upgrade their benefit coverage higher than that which their account balances would qualify them for, may, at the beginning of each Plan Year (April 1st), pay the cost of a higher level of benefit coverage. This pay direct option is offered subject to any Insurance Company restrictions.

New Members to I.A.T.S.E. Local 667 or Local 669 will have the option to remain at Benefit Level 01 or to voluntarily upgrade to Benefit 02 before the next Plan Year which begins April 1st. This option will be available 90 days after the date the individual becomes a Benefit Plan Member. The Member must pay the full cost of the higher level of benefit coverage for the months up to the next Plan Year. Any producer contributions made before becoming a Plan Member will be applied to the account balance for the next Plan Year.

A Member must maintain, year-to-year, any voluntarily elected higher benefit level. Once a Member voluntarily upgrades and later opts for a lower benefit, it is on penalty of losing the right to voluntarily upgrade again for at least 36 months.

CAN I APPOINT ANYONE AS MY BENEFICIARY?

The appointment of a beneficiary(ies) must be submitted in writing to the Health & Welfare Administration Office.

You may appoint a beneficiary(ies) by completing an application form and sending it to the Health & Welfare Administration Office, subject to any law or government regulation which may apply. The beneficiary appointment will take effect on the date of your appointment, if you properly file the application form (but will not apply to payments made before you complete the form). The Life Insurance and Accidental Death & Dismemberment Insurance benefits will be paid to your most recently appointed beneficiary(ies), or your estate if your appointed beneficiary(ies) are deceased or you have not made a beneficiary appointment.

• Minors:

If your beneficiary is a minor, under 18 years of age, it is advisable that you name a Legal Trustee to receive any amount due to the beneficiary, and declare that payment to such Legal Trustee shall be a good discharge to the Insurance Company for the amount paid.

• Irrevocable Beneficiaries:

The appointment of any beneficiary is revocable unless you are a resident of Quebec. In Quebec the appointment of a spouse as beneficiary is irrevocable unless designated revocable by the spouse. If you are not a resident of Quebec any beneficiary appointment is revocable, unless designated irrevocable. The beneficiary appointment shall apply to all benefits for which the appointment is provided under the Plan.

FRAUD & MISREPRESENTATION

The Board of Trustees reserves the right to deny the payment of a claim for benefits if a Member or the Member’s dependent(s) participates in the deliberate provision of incorrect information, the misrepresentation of an expense previously reimbursed, or any other fraudulent practice with respect to filing a claim.