Where do I call for benefits information?
Any time you have questions concerning your benefits or eligibility,
call the Fund Office at
(707) 864-3300 or the toll-free number 1-888-245-5005. The
Fund Office hours are between 8:30 A.M. and 4:00 P.M.,
Monday thru Friday. If you wish to write, send your mail addressed
to Northern California Cement Masons Funds Administration, 220 Campus Lane,
Fairfield, California 94534-1499. You can also email the Fund Office
at customerservice@norcalcementmasons.org.
What do I do if I lose my health plan
ID card?
No need to worry. Just contact the Fund
Office or send email to customerservice@norcalcementmasons.org to request a new card. In the meantime, you can still access your
health coverage. To do so, you need to know the following:
- Group Number
- Active Plan - Group
Number: 1790KA;
- Retired Plan - Group
Number: 1790KB;
- Retired with Medicare - Group
Number: 1790KJ.
- Social Security Number
- If you need medication, give the pharmacy your Group
Number and your Social Security number.
- If you are a regular customer, you will probably not
need to present a card. The pharmacy should have all the
information needed to fill your prescription.
- Toll-Free Numbers
- Cement Masons Fund Office: 1-888-245-5005
- Prescription Solutions: 1-800-562-6223
(TDHI customers use 1-800-498-5428)
- Utilization Review (Pre-Authorization/Pre-Service
Review): 1-800-274-7767 (Note: This
is the toll-free number that the hospital where
you are staying should
call to arrange utilization review for elective
and emergency inpatient stays. Utilization
review only authorizes the
number of days that are medically necessary
for a hospital stay; it does not verify eligibility.
To verify eligibility,
the hospital must contact the Fund Office).
Any health
care provider or hospital can contact the Fund Office at the above number between the hours of 8:30 A.M.
and 4:00 P.M., Monday through Friday to verify eligibility
or resolve any benefit matter that may arise.
If you are having a problem accessing your prescription
drug coverage, you or your pharmacist can contact Prescription
Solutions at 1-800-562-6223
(TDHI 1-800-498-5428). Prescription Solutions customer service
is available Monday - Friday from 6:00 A.M. to 9:00 P.M.
(Pacific Time) and on Saturday and Sunday from 7:00 A.M. to
7:00 P.M. If Prescription Solutions cannot resolve the
problem, contact the Fund Office.
You should
receive your replacement card within two weeks of the date
you order it. If you do not, contact the Fund Office immediately.
Why is it important for me to keep
my payroll records (check stubs)?
It is vital to always keep your pay stubs with
your other employment records. In case a discrepancy occurs between
your records and
the Fund’s records, which affects your eligibility to a Pension
benefit, Vacation/Holiday benefit and Health and Welfare coverage,
your pay stubs will likely determine your eligibility.
What does a Statement of Account tell
you?
Besides vital information, such as your name and social security
number, the statement shows your six-month work period for purposes
of establishing health and welfare eligibility, pension benefit
accruals, and vacation/holiday dollars. The statement lists the
names and account numbers of employers reporting hours for you
and shows the month and year you worked those hours. There are
three columns listing health and welfare hours, pension hours,
and vacation/holiday amounts, in dollars. A couple of important
reminders:
- if your employer reported hours but did not pay health and
welfare contributions, those worked hours cannot be used toward
eligibility for health and welfare;
- if your employer did not pay vacation-holiday hours worked,
that amount will remain in suspense and unpaid to you until your
employer submits the required payment to the Trust Fund.
What should I do if there is an error
on the Statement of Account?
As soon as possible, review your statement carefully. If you believe
any information is incorrect, and that can be from the social security
number to the number of hours reported, contact your Local Union.
Your Local Union will work with the Fund Office to resolve any
discrepancy. For example, if you believe all of your hours are
not shown, you may be asked to submit copies of payroll stubs.
(Remember, save those payroll stubs.) It can be a simple problem,
such as, hours reported under another social security number. Your
payroll stubs will help clear that up.
What should I do if all of my work
hours do not appear on the Statement of Account?
First, get into the habit of saving all of your paycheck stubs
and verifying that all hours worked appear on your Statement
of Account. If you believe all hours have not been reported,
mail copies (not originals) of your paycheck stubs into the Fund
Office. (Do not mail all paycheck stubs - only those pertaining
to the month or months in question.) Mail your paycheck stubs to
Northern California Cement Masons Funds Administration, Employer
Accounts, 220 Campus Lane, Fairfield, California 94534-1499.
We will investigate and notify you of the results, in writing.
What should I do if I do not receive a Statement
of Account?
If you worked during the six-month period and do not receive a
statement, chances are we do not have your current address. Again,
contact your Local Union who
will help in verifying your correct address. If necessary, you
may need to complete an Enrollment Form to update the
records. Another explanation could be that your employer has not
reported your hours. Again, work with your Local Union in resolving
this situation. Above all, verify the information on this document.
In effect, it is your work record and so many of your benefits
rely on its accuracy. Retain it for future reference. You will
want to compare it to your vacation-holiday payment due November 30
and to your Pension Statement, mailed in December. Follow these
same guidelines when you receive your next Statement of Account,
scheduled for mailing in September of each year.
My employer has refused to pay my
contributions to the Trust Funds. What can I do to help the Trust
Funds collect what is due me?
First,
it is important to have saved copies of your check stubs
with the job site and prime contractor information written
on each stub. Contact the Accounts
Receivable Department at the
Fund Office with the information
or copy the check stubs and mail them to the Fund Office. Remember-the
more detailed
and timely the information, the better the chances of collecting
those contributions.
What is “KAISER”?
Kaiser Permanente is an HMO Plan (Health Maintenance
Organization). It is a prepaid medical group practice plan which
provides comprehensive medical benefits.
What is a “PPO”?
PPO stands for “Preferred Provider Organization”.
It is a group of hospitals and physicians contracting on a fee-for-service
basis with insurance companies to provide comprehensive medical
service. It differs from Kaiser in that you are free to choose
your own health care provider. The Fund’s own “Managed
Health Care Plan” is a PPO.
What is “COB”?
COB means “Coordination of Benefits” and
is a process designed to eliminate duplicate payments and apply
primary and secondary coverage when a participant is insured under
two health plans.
What is the Plan definition for the
word Physician?
Your health and welfare plan defines Physician as “(a)
a physician and surgeon (M.D.) licensed to practice medicine in
the state in which he practices and (b) any other practitioner
of the healing arts who renders care or treatment within the limits
set forth in the license issued to him by the applicable agency
of the state in which he renders such care or treatment.” Among
the practitioners of the healing arts are Certified Acupuncturists
when treatment is for a pain-related diagnosis; nurse midwives
for obstetrical care, provided services are performed in a hospital
(as defined by the Plan); nurse practitioners; and a licensed Ph.D.,
M.F.C.C., or L.C.S.W. If you wish to check whether a health care
provider fits the definition of Physician, contact
the Fund Office.
What is COBRA?
In 1986, an important piece of legislation was
enacted into law, allowing employees to continue benefit coverage
after employment
ceased. Actually, the continuation of benefits was only a small
part of the budget bill that came to be know as COBRA, short for “Consolidated
Omnibus Budget Reconciliation Act”. What is important to
know is COBRA can offer a safety net for someone facing the loss
of health coverage. Under the law, COBRA allows an individual whose
eligibility terminates to continue health plan coverage under certain
circumstances. Key to understanding the provisions of COBRA are
the terms “Qualified Beneficiary” and “Qualifying
Event”.
Who is a “Qualified Beneficiary” under
COBRA?
As defined under COBRA, a Qualified Beneficiary is an individual
who loses coverage under any of the Qualifying Events described
below. A Qualified Beneficiary can be an active employee, his spouse
or dependent child.
What are COBRA “Qualifying
Events”?
If you are the employee, Qualifying Events are:
- termination of employment, or
- a reduction in hours.
If you are the spouse or dependent child, Qualifying
Events are the same as for the employee, plus:
- the employee’s death, or
- your divorce from the employee, or
- the dependent child no longer meets the plan’s definition
of “Dependent”.
If the Qualifying Event is a termination or reduction of hours,
the Fund Office notifies you. If the Qualifying Event is a death,
divorce or a child losing dependent status, the Qualified Beneficiary
should notify us.
What is the cost and how long will
coverage last while under COBRA?
The monthly premiums are set each March by the
Board of Trustees and do not change for 12 months. The cost is determined by
the type of coverage you elect and whether you are buying coverage
for yourself or for both yourself and your family. The duration
of coverage can be from 18 to 36 months. Generally, coverage
is for 18 months, but can be extended to 36 months if
a second Qualifying Event occurs or to 29 months if Social
Security determines that a qualified beneficiary is totally disabled.
The provisions of COBRA are too numerous and complex to fully cover
in the space allotted here. For more information on your rights
to elect COBRA continuation coverage, refer to your Plan booklet
or contact the Fund Office at
(707) 864-3300 or toll-free at 1-800-245-5005 and ask for
the COBRA section. You may also email us at customerservice@norcalcementmasons.org.
How do I sign up for a plan or switch to
another plan?
Contact the Fund Office,
which will send materials to you such as a Comparison of Benefit
Plans, any plans available in your area and an Application
Form. If you are retired, a Rate Sheet or monthly
premium of different plans is also enclosed. You should review
the materials thoroughly and then carefully decide which plan is
best suited for you and your family’s needs. Complete the Application
Form for the plan you selected and return it to the Fund Office
before the deadline indicated on the form.
What are the requirements for becoming
a Participant in the Cement Masons Pension Plan?
Article 2 of the Pension Plan provides that an Employee becomes
a Participant on August 1 or February 1 next following
a 12-consecutive month period during which at least 300 hours
in Covered Employment or Continuous Non-Covered Employment with
a Contributing Employer were worked. An easy example is that of
an Employee who first starts working in Covered Employment on February 1, 1998.
If a total of 800 work hours are accrued by January 31, 1999
(a full 12 months later), the employee would then become a
Participant on February 1, 1999. Once an Employee becomes
a Participant, Credited Service and Benefit Units are received
for those hours worked before becoming a Participant.
Can you lose Participation in the Cement
Masons Pension Plan?
If you do not work at least 300 hours during a Plan Credit
Year, which is February 1 through January 31 of the following
year, you will incur a One-Year Break in Service and will cease
being a Participant on the last day of that Plan Credit Year. Of
course, by working at least 300 hours during a Plan Credit
Year, you will again become a Participant on the February 1
following. Besides active Employees, Pensioners and former Employees
who have attained “Vested” status are also Participants
in the Plan.
What does the Pension Plan say about
transferring hours from one Plan Credit Year to another?
The Pension Plan does not allow you to transfer
hours from one Plan Credit Year to another. Your Pension Plan
defines a “Plan
Credit Year” as the period from February 1 of any year
through January 31 of the following year. It is the 12-month
period used to determine Credited Service, Benefit Units and benefit
accruals. Only hours worked during that 12-month period can be
used to determine Credited Service, Benefit Units and accruals.
How much is my Pension worth?
One of the most commonly asked questions of the
Pension Department is “How much is my pension worth?”; If you are a Plan “Participant,” (see
sidebar article), the Pension Plan is required to provide you with
an estimate of what your pension benefit would be at Normal Retirement
Age, defined as age 65. Your request for an estimate must
be in writing and is not required to be given more than once a
year.
Unlike a “defined contribution plan”, benefits under
a “defined benefit plan” do not accrue a cash value.
As you work in covered employment, you earn Years of Credited Service
and Benefits Units. Credited Service and Benefit Units translate
into a monthly benefit once you meet all the conditions of entitlement
to a pension. These conditions include filing an application and
stopping work as a Cement Mason.
When you do request an estimate of your pension
benefit, we advise that it is only an estimate with certain conditions
attached to
it. The pension estimate most commonly provided is the Normal Retirement
Age (age 65) benefit or “Regular Pension”. This
estimated benefit is calculated only for those cement masons who
have attained vested status in the Plan. If you are not yet vested,
we cannot calculate an estimated benefit, however, we will inform
you of how many more years you have to work to become vested. (For
rules on vesting, see Section 3.16 in your Pension Plan booklet.)
If you are vested with less than 8 Years of Credited Service,
only the Normal Retirement Age benefit applies, as you do not qualify
for any other type of pension. If you are vested with 8 or more
Years of Credited Service, we can provide an estimate of an Early
Retirement Age (age 55) benefit. If you are age 55 or
older and have accumulated 25 or more Benefit Units, we can calculate
a Service Pension benefit, which is the same as the “Regular,” (Normal
Retirement Age) benefit. To learn more about the different types
of pensions available, refer to Article 3 in your Plan booklet.
Vesting Status, Years of Credited Service, Benefit Units and your
age are all factors to keep in mind when requesting an estimate
of your pension benefit. Also keep in mind that benefits have improved
steadily over the life of the Pension Plan. What may be a reasonable
estimate today, may not apply on the date you retire.
The Plan booklet can also guide you in estimating
your own benefit. Start with the example of the “Regular Pension” shown
on page 17 of your Plan booklet and plug in your own work
history. In calculating your benefit, be sure to use the most current
benefit unit factors. You can also estimate a benefit for an Early
Retirement Pension using the example on page 18.
The staff in the Pension Department is ready to assist you in
estimating your benefit. The Fund also has a Field Benefit Representative
who visits local unions and can provide assistance. Keep in mind,
though, until you actually retire, that is, establish entitlement,
file an application, and stop working as a Cement Mason, any figures
quoted are only estimates.
What are the 46 Northern California counties
represented by the Trust Fund?
These counties are also known as the “Preferred Provider
Service Area” for hospital-medical benefits reimbursement:
