How do I get assistance?
If you have any questions about your plan, 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, contact the nearest Area 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 publications hotline of the Pension and Welfare Benefits Administration.

What is meant by "Agreement and Declaration of Trust"?
The term “Agreement and Declaration of Trust” means the instruments establishing the Local 804 Welfare Trust Fund entered into as of the [ ] and amended from time-to-time.

What is meant by "Collective Bargaining Agreement"?
The term "Collective Bargaining Agreement" means the collective bargaining agreement in force and in effect between the Union and Contributing Employers, together with any modifications or amendments thereto.

What does "Covered Employee stand for?
The term "Covered Employee" means any person who is employed full time by an Employer under a Collective Bargaining Agreement between the Union and the Employer. This includes all Local 804Welfare and Annuity Fund Office employees and Union officials.

What will I do in an Emergency situation?

If you have questions about a health situation and/or emergencies, you should call your personal physician for advice. Your personal physician will direct you to the appropriate care setting.

Call an ambulance or go directly to an emergency room if you cannot call your personal physician in advance. If possible, go to the emergency room of the hospital where your personal physician is affiliated.

How does Empire Blue Cross and Blue Shield work?
When your doctor recommends an elective or non-emergency hospitalization for you or a covered dependent, you must call Empire Blue Cross and Blue Shield toll free at 1-800-533-9603 to initiate the pre-certification process. The call should be made as soon as possible before admission between the hours of 8:30a.m. – 5:00 p.m., Monday through Friday. If you call during non-business hours, the call will be answered by an automated system.

Once you have called Empire Blue Cross and Blue Shield, they will contact your doctor for further information and you will receive a confirmation of the admission and the expected date of your discharge.