Life Insurance
The amount of your Life Insurance shown in the Schedule of Benefits on page 8 of the Summary Plan Description will be payable to your beneficiary upon your death from any cause while insured. A claim form and certified copy of the death certificate must be provided to the Trust Fund Office.
The insurance amount is payable in a single sum unless you choose to have it paid in installments. If you do not choose a method of payment, your beneficiary may do so after your death in a written notice sent to the Trust Fund Office.
- Your Beneficiary
- Right to Convert Life Insurance
- Waiver of Premium During Disability
- Qualifying for Waiver of Premium
- Amount of Life Insurance Continued Under Waiver of Premium
- If You Die Before Qualifying for Waiver of Premium
- If You Convert and Also Qualify for Waiver of Premium
- Termination of Waiver of Premium Benefit
- Maximum Payment of Benefits
Your beneficiary may be any person or persons you name on your beneficiary designation card. Beneficiary cards are kept on file in the Trust Fund Office. You may request a change of beneficiary at any time by submitting a new beneficiary card. The latest signed and dated beneficiary card on file will be the one honored in the event of your death. The insurance company will honor a request for change in beneficiary only if it is recorded before any Life Insurance payment has been made.
If you name more than one beneficiary and you do not state the interest of each, they will share equally. If you do not name a beneficiary or if your named beneficiary does not survive you, the Life Insurance amount will be paid to the surviving person or persons in the first of the following classes:
(a) your legal spouse or Registered Domestic Partner,
(b) your children,
(c) your parents,
(d) your brothers and sisters,
(e) your estate.
This beneficiary determination order will also apply to accidental Death & Dismemberment benefits payable, if any. No beneficiary designation will be considered valid until it is received and recorded by the Trust Fund Office. The insurance company may, at its option, pay up to $500 of this Insurance to any person it determines is entitled to receive payment. This person must have satisfactory proof that he or she paid for funeral or other expenses resulting from your last illness or death.
If you die after your Life Insurance provided by the Plan terminates and you have been issued an individual policy (see "Right to Convert" under Life Insurance), payment will be made to the beneficiary you named in your application for the individual policy.
RIGHT TO CONVERT LIFE INSURANCE
If your insurance terminates, you may convert to an individual policy of life insurance without evidence of insurability, subject to the following:
1. If all or part of your Life Insurance terminates while this group policy is in force because: (a) you are no longer employed or lose coverage because of insufficient hours; or (b) your Premium Waiver benefit terminates; or (c) the amount of your Life Insurance is reduced; then you may convert all or a portion of the Amount of Insurance that has been terminated.
2. If this group policy is either canceled by the Trust Fund or changed to no longer provide Life Insurance, and you have been continuously insured for at least 5 years immediately preceding the date your life insurance terminates, you may convert a limited amount of the terminated insurance. You may convert the smaller of: (a) the amount of this terminated insurance less any amount of other group Life Insurance you may be eligible for within 31 days after this insurance terminates, or (b) $2,000.
If a Dependent’s Life Insurance terminates for any reason, he or she will be entitled to convert on the same basis as the member.
The individual policy will be a policy customarily issued by the insurance company at the time of conversion. It will not provide term insurance, Accidental Death, Dismemberment, or Loss of Sight benefits, disability benefits or any other supplemental benefits.
To obtain an individual conversion policy, you must make written application to the insurance company and pay the required premiums within 31 days after your group Life Insurance terminates. You cannot get a conversion policy by applying later. If an individual policy is issued, it will take effect at the end of the 31-day conversion period. The premium for your policy will be based on your age as of your nearest birthday on the conversion policy's effective date.
If you should die within the 31 day conversion period, the amount of Life Insurance you are entitled to convert will be payable under this group policy. This amount is payable even if no request for conversion is made.
If you become Totally Disabled prior to your 60th birthday and while insured under this group policy, you may qualify for the Waiver of Premium benefit. If you qualify, your Life Insurance will be continued without payment of premiums for as long as you remain Totally Disabled and otherwise qualify. This benefit does not apply to Dependent Life coverage
To first qualify for this Waiver of Premium, you, or someone on your behalf, must give written proof satisfactory to the insurance company that you are Totally Disabled. The proof must also show that your Total Disability began before your 60th birthday and has continued for at least 9 months. The Company must receive this proof at its Home Office between the 9th and 12th month after the date you stopped being actively at work. If the proof is not received by the Company before the end of the 12th month, your insurance will not be continued. If you qualify, your Life Insurance is continued for 12 months from the date premium payments on behalf of the member cease; the date Total Disability began; or the date the application for waiver is approved; whichever occurs first.
To continue to qualify for the Waiver of Premium benefit for additional 12-month periods, you, or someone on your behalf, must give written proof satisfactory to the insurance company showing that you continue to be Totally Disabled. This proof must be received by the Company at its Home Office between the 9th and 12th months of each successive 12-month period. It is up to you or someone on your behalf to send the proof to the insurance company on time. The Company will not ask for the proof or remind you to send it. If you fail to send sufficient proof, your coverage will terminate at the end of the 12-month period for which proof had been supplied.
The insurance company has the right to have a physician of its choice examine you periodically. This exam will be paid for by the Company.
The amount of Life Insurance continued under the Waiver of Premium benefit will be the amount in force on the date you stopped being Actively at Work. The continued amount of insurance will be subject to the same reductions that would apply if you were still insured on a premium-paying basis under the plan of insurance in force on the date you stopped being Actively at Work. The amount of your continued insurance will also be reduced at the time you are issued any individual conversion policy by the amount of that conversion policy, unless you surrender the conversion policy (without claim for benefits) to the Insurance Company at its Home Office. While your Life Insurance continues under the Waiver of Premium Benefit, changes in benefits made by the Trust Fund will not apply to you.
If you die within 12 months after the date you stopped being Actively at Work but before the Company approved continuation of your insurance under the Waiver of Premium benefit, then a death benefit is payable provided:
1. you totally disabled; and
2. your total disability began before your 60th birthday; and
3. you stay totally disabled from the date you stopped being actively at work until the date of your death; and
4. the insurance company receives satisfactory written proof of claim at its Home Office within one year after your death.
If you convert to an individual policy and you are also approved for the Waiver of Premium benefit, the Company will refund all premiums you paid under the conversion policy if you surrender it without any claim for benefits. If you elect to keep the conversion policy, the amount of insurance continued under the Waiver of Premium benefit will be reduced by the amount of the conversion policy.
Life Insurance continued under the Waiver of Premium benefit will terminate on the earliest of the following:
1. the date you are no longer totally disabled;
2. the date you refuse to have an exam if requested;
3. the end of any 12-month period in which the insurance company does not receive proof satisfactory to the Company that shows you continue to be totally disabled.
If your insurance continued under the Waiver of Premium benefit terminates, you may then have the right to convert during the 31-day period beginning on such termination date.
The total benefit under this policy for Life Insurance will never exceed the Amount of Insurance shown in the Schedule of Benefits Section. In no event will payment be made under more than one of the following Life Insurance provisions:
• Life Insurance Benefit;
• Waiver of Premium; or
• Conversion Privilege
Need to Report a Death?
To report a death, please call the Trust Fund Office at (619) 358-8145 (local) or 1(877) 898-7155 (toll-free), Monday through Friday, between the hours of 7:00 a.m. and 6:00 p.m., Pacific Standard Time.
Be prepared to provide the following information:
- Member's SSN (if available)
- Name of Deceased
- Deceased Relationship to Member
- Date of Death
- Who to contact (Name, Relationship, Telephone Number and Address)
Someone will contact the designated beneficiary within 2-3 business days for additional information.
Make sure to Keep Your Designated Beneficiary Up to Date
To update your designated beneficiary, please complete the Designation of Beneficiary(ies) section of the Enrollment/Change Form and submit it to the Trust Fund Office for filing.