IBEW #481 Money Purchase Pension Plan & Trust

Terminated Vested Participant Application

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You will need to provide the following documents:

There will be two separate distributions issued.  The first distribution will be for 80% of your last known account balance.  The remaining balance will be paid to you approximately 60 days from the last day of the quarter in which you made application (after earnings have been applied to your account).  The quarters end on March 31st, June 30th, September 30th and December 31st. 

EFFECTIVE JANUARY 1, 2010 THE PLAN NO LONGER PROVIDES SUBSTANCE ABUSE BENEFITS.  The Quality Connection's Employee Assistance Program (EAP) will continue to provide confidential counseling services through the Methodist Assistance Program (MAP).  To contact MAP, 24 hours a day / 7 days a week, please call (317) 962-2622 or (800) 745-4838.

Effective January 1, 2008 the Trustees established a Health Reimbursement Account (HRA). To view the HRA policy, please visit the "Summary Plan Description - Benefit Fund Summary of Material Modifications" below.  The current employer contribution rate to your individual HRA account is $0.50 per hour.  These monies can be used for certain expenses, as allowed by law.  Click here to view IRS Publication 502 for a list of  includible and not includible expenses.  Claims on the HRA account must be filed within 6 months of the date the expense was incurred. Eligible claims must total a minimum of $25.00 per person.

H.R.A. Forfeiture Rules (click here)
Your pre-certification and managed care provider is DBMS. The Trustees request that you contact DBMS for all in-patient admissions and for all out-patient services at 1-800-728-0327.  For more information, please visit http://www.dbms-inc.com/ or click on the DBMS link in the menu on the left side of this page.
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ALL ELIGIBLE RETIREMENTS REQUIRE THE FOLLOWING ITEMS:
1.  Your birth certificate
2.  Your spouse's birth certificate (if applicable)
3.  Your marriage certificate (if applicable)
4.  Your divorce decree (if applicable)
5.  Your termination slip 

Please contact Bob Cadwell at (317) 923-4577 for an individual retirement planning appointment.
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Benefits Online Links:

Benefits Login
For your first time login, you will be required to have your Social Security number for the ID (do not use the dashes. ie: 123456789) and use GEN4681 as the password. Follow the on-screen instructions to complete your sign in process.

Money Purchase Plan Earning Rates

Prescription Benefit Manager: SAV-RX Site

 

Summary Plan Descriptions(SPD):

Benefit Fund (revised January 1, 2012)

Amendment - Genetic or chromosomal testing, counseling or therapy is a covered service for Oncotype Dx, Brac 1 and Brac 2 testing if the test is found to be Medically Necessary and the patient is in stage one or stage two of breast cancer and testing for Factor V Leiden prior to undergoing Hormone Replacement Therapy.

Pension Fund

Money Purchase Plan

 

Forms and Information:

Designation of Beneficiary Form HIPAA Privacy Notice
 
Participant Data Card Claim Form
 
Claim Appeal Procedure Loss of Time Statement
 
Annual Enrollment Form Subrogation Agreement Form
 
Change of Address Form HIPAA Authorization Form
 
Loss-of-Time Tax Form Eligibility Requirements Chart
 
Dental Preferred Providers Suspension of Pension Benefit Application
 
Anthem Claim Form Direct Deposit Form
   
Health Reimbursement Account (HRA) Claim Form Summary of Death Benefits
 
H.R.A. Claim Form (PDF version)  Retiree Return to Employment Form
C.H.I.P. Notice 

Tax Withholding Form - Pension 
   
   
   

 Additional Links:

Anthem

DBMS (for Pre-Certification and Case Management)

Prescription Benefit Manager: SAV-RX Site

ProCare Network

Methodist Assistance Program

E.R.T.S. (Electronic Reciprocity Transfer System)

Health Reimbursement Account (HRA) Publication 502 Regulations

YMCA OF GREATER INDIANAPOLIS http://www.indymca.org/
 

  

ELECTRICAL WORKERS FRINGE BENEFIT
ADMINISTRATIVE OFFICE

Robert G. Cadwell, Administrative Manager
1828 N. Meridian Street, Suite 103
Indianapolis, IN  46202

(317) 923-4577
Fax: (317) 923-7633

email: info@ewbtf.org

Office Hours:
M,T,TH, F = 8:00 A.M. to 4:30 P.M.
W = 8:00 A.M. to 6:00 P.M.

 

 

 

© Copyright 2003,2004, International Brotherhood of Electrical Workers Local Union #481, All Rights Reserved.