Eligibility for Life Insurance and Accidental Death and Dismemberment Insurance Benefits
Eligibility for the Life Insurance Benefit and Accidental Death and Dismemberment Insurance Benefit for covered individuals begins on the date you meet the eligibility requirements. You do not have to wait until the beginning of the next insurance quarter to become eligible for these benefits.

Life Insurance for a Participant
If you are eligible for benefits, you are eligible for a Life Insurance Benefit in the amount of $50,000, payable to the beneficiary named by you, in a lump sum, in the event of your death from any cause at any time while you are eligible.
 
Beneficiary Designation and Payment
You may designate a beneficiary by completing an enrollment card and submitting it to the Welfare Fund Office. Such designation or change will take effect as of the date such request is received at the Fund Office regardless whether you are living at the time of such filing but without prejudice to the insurance company on account of any payments made by it before receipt of such request at the Fund Office.

Click here to download and print the Enrollment and Life Insurance Beneficiary Designation Form.

Any amount payable to a beneficiary will be paid to the beneficiary or beneficiaries designated by you unless otherwise specifically provided by you in your beneficiary designation in accordance with the following rules:
 

1. If more than one beneficiary is designated, the designated beneficiaries will share equally;
2. If any designated beneficiary dies before you the share that such beneficiary would have received if he/she had survived your death will be payable equally to the remaining designated beneficiary or beneficiaries, if any, who survive the participant; and
3. If no designated beneficiary survives you or if no beneficiary has been designated, payment will be made to:
   
   1. Your widow or widower, if surviving you; or
   2. if no spouse survives you, in equal shares to the your children who survive you; or
   3. if no children survive you, to your living parents equally, or to the surviving parent; or
   4. if neither parent survives you, in equal shares to your brothers and sisters who survive you; or
   5. if no siblings survive you, to your estate.

In any case, however, the insurance company may deduct from the amount payable an amount to be applied for funeral and other expenses related to your last illness and death, but only when and to the extent this is desirable and equitable in its judgment.
 
Disability Death Benefit Extension
If you become totally and permanently disabled while you are eligible for the Life Insurance Benefit and before you reach age 60, the Fund will continue your Life Insurance Benefit by paying the required premium as long as you remain disabled and the group policy remains in force, provided proof of disability are furnished as required. The first proof should be filed with the Fund Office, Attn: Participant Services Dept., within three (3) months after loss of eligibility. Subsequent proof of disability may be required. In the event the group policy is discontinued, your Life Insurance Benefit will terminate.
 
In no event will an extension of the death benefit be granted unless an application for the extension is filed within one year after loss of eligibility. Applying or qualifying for a disability benefit with the Pension Fund does not constitute application for this Disability Death Benefit extension. A separate application with the Welfare Fund is required.
 
Life Insurance for a Dependent
If you are eligible for benefits, your dependents are eligible under the Active Plan of benefits for a benefit payment in the amount of $2,500 in the event of the death of a spouse and $2,000 in the event of the death of a covered dependent, at any time or place, if the death occurs while your spouse or dependent child is covered under the Plan.
 
If your dependent dies while dependent coverage is in force for that dependent, the insurance company will pay you if you are still living at the time of payment, otherwise to your estate, or, at the option of the insurance company, to your surviving spouse.
 
Life Insurance Benefits under Cobra Continuation Coverage
Life Insurance Benefits are not available under COBRA Continuation coverage.
 
Life Insurance Benefit under the Low Cost Medical Plan
Under the Low Cost Medical Plan, you are eligible for a Life Insurance Benefit in the amount of $5,000, payable to the beneficiary named by you, in the event of your death from any cause at any time, if death occurs while you are covered under the Low Cost Medical Plan.
 
Your spouse and dependent children are eligible for a Life Insurance Benefit in the amount of $1,000 each, payable to you, or in the event of your death to your estate, in the event of the death from any cause, at any time or place, if the death occurs while your spouse or child is covered under the Low Cost Medical Plan.
 
Forms
Life insurance benefits are underwritten by Aetna. Click here to download and print the Aetna Life Insurance Disability Claim form. This form should be completed in full and returned to the Fund Office, Attn: Participant Services Dept. along with a certified original death certificate.
 
Remember to notify the Participant Services Dept. at the Fund Office of any death as soon as possible.

Eligibility for Life Insurance and Accidental Death and Dismemberment Insurance Benefits
Eligibility for the Life Insurance Benefit and Accidental Death and Dismemberment Insurance Benefit for covered individuals begins on the date you meet the eligibility requirements. You do not have to wait until the beginning of the next insurance quarter to become eligible for these benefits.