FAQ

What is a pension credit?

Pension credits determine the monthly amount of your pension benefit. In general, you earn one pension credit for each calendar year in which you work at least 1,200 hours in covered employment. If you left covered employment before January 1, 1990, the way your pension credit is determined may be different. See your Summary Plan Description for details about how pension credit is earned.

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What is a special service credit?

Special service credits are an additional credit amount you may receive when you work more than the hours needed to earn a full pension credit. As of January 1, 2003, you receive a special service credit amount of $5.50 for every 300 hours you work in excess of 1,200 hours in a year (up to 2,100 hours). The special service credit was introduced in 2000 ($3.00 for every 300 hours over 1,200) and the amount will change from time to time. Special service credits are used to increase the amount of your pension, but they can’t be used to help you meet the eligibility requirement for a benefit.

For example, suppose you work 1,800 hours in 2003. You receive a special service credit of $5.50 for every 300 hours you work past 1,200 in that calendar year. Because you worked an additional 600 hours, your two special service credits total $11.00 ($5.50 $5.50) for the calendar year. The $11.00 is added to the amount of your regular pension credit.

Suppose you retire in 2003 at age 62 with 35 pension credits and 8 special service credits (two per year 2000-2003). You qualify for a Regular Pension of $1,553.50 per month (35 credits x $43.50 = $1,522.50 plus two special service credits x $3.00 plus four special service credits x $3.50 plus two special service credits x $5.50 = $31.00 per month for a total of $1,553.50 per month) before any reduction for the Husband-and-Wife Pension or for optional forms of payment.

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What is the current benefit accrual rate?

Effective April 1, 2001, the benefit accrual rate per pension credit is $43.50. This accrual rate generally applies to you if leave covered employment on or after April 1, 2001.

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When Should I Apply for My Pension?

The Effective Date of your pension is dependent upon how quickly you return the Pension Application and all other mandatory pension documents to the Fund Office. No pension benefits will be paid for any period prior to the first day of the month following the month in which the Participant has submitted all of the appropriate documentation to the Fund Office. A Participant must have all necessary supporting paperwork on file within 90 days after the pension application is received by the Fund Office. If a Participant does not have all the necessary supporting paperwork on file within 90 days after the pension application is received by the Fund Office, then the application will be closed and the Participant must re-apply for pension benefits and will be given a new Effective Date.

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What are the eligibility requirements for a Regular Pension?

You are eligible for a Regular Pension if you:

1. are 62 or older; and
2. have at least 10 pension credits.

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Are annual physical check-ups covered?

Yes. Wellness benefits (annual check-ups and certain covered related expenses) for you, (the employee) and your spouse are covered as described in the Wellness Expense Section of your SPD. Routine child and adolescent immunizations and routine physician examinations or check-ups are covered under the Comprehensive Major Medical Benefit for eligible dependents.

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My physician has recommended physical therapy for me. Is coverage provided for this treatment?

Medically Necessary physical therapy is covered. Please have your physical therapy provider contact the Fund Office at (708) 449-7373 to pre-certify therapy.

ELIGIBILITY OF DEPENDENTS

 

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My doctor gave me a prescription for birth control pills. Why was my claim denied?

All forms of contraceptives, including medicines and devices, are not covered under the plan, unless they are Medically Necessary.

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When does a Participant Become Eligible for benefits from their Annuity?

1) Upon retirement; 2) if a participant becomes totally disabled (must submit a copy of their Social Security Disability Award Letter); 3) Upon termination of employment in the sheet metal industry (the participant’s employment is considered terminated if no contributions have been paid to the annuity fund on their behalf by a contributing employer for at least six consecutive months example:  A participant has no hours reported for the six month period of Jan 1^st  through June 30^th, since hours are reported in the month following the month worked, this participant would be considered terminated effective July 1^st as of August 1^st in order to be eligible to withdraw or rollout any portion up to the full amount of their account);  4) upon death of the participant.

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How can I find out my current Annuity account balance?

Your Annuity Plan with Fidelity Investments offers you easy access through NetBenefits 24 hours a day:  www.netbenefits.com/atwork or by phone by calling the Fidelity Retirement Services Center at 1-866-84UNION (1-866-848-6466).

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What withdrawal options are available to a participant from their annuity account?

Active:     

- Full or Partial Withdrawal or Rollover

(if the participant has a current six (6) consecutive month break of zero hours reported by a contributing contractor on their behalf)

- General Purpose Loan

- Hardship Loan

- Hardship Withdrawal

- Age 59½ Or Older Withdrawal

                 

Retiree:     

- Full or Partial Withdrawal or Rollover

- SWP - Systematic Withdrawal Payments

- Elect to purchase a fixed or variable annuity 

  (with a 50% or 75% J&S options)

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What is the General Purpose Loan?

Effective January 1, 2020, the maximum General Purpose Loan amount was increased to $20,000.  Therefore, a participant may take out one General Purpose Loan (GPL) for a minimum amount of $1,000 to a maximum of $20,000 for any other reason not allowed under the Hardship Loan provision during any twelve (12) consecutive month period.  This loan amount shall not collectively exceed the lesser of:  (a) 50% of the vested balance in the participant’s account; or (b) $20,000.

A Participant must repay the general purpose loan and may elect to have monthly repayments for a maximum time period of five years or sixty (60) payments.  A participant may pay off the loan any time before the due date without penalty.  Repayment of the GPL starts within 35 days from the origination date of the loan.

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What is the Hardship Loan?

A Hardship Loan or loans from the Money Purchase Plan cannot collectively exceed 50% of the vested balance in the participant’s account; or $50,000, whichever is less.  Hardship loans require that a participant has an immediate and heavy financial need and the hardship loan is in an amount up to the amount of the need.  Proof of the reason is required for this type of loan.  Repayment provisions are the same as mentioned above for the GPL.  Specifically, the financial need must be due to any one or more of the (4) following reasons:

1. Medical care expenses as described in Internal Revenue Code Section 213(d) (already incurred or necessary in the future) for the Participant or Participant’s spouse or the Participant’s dependent, as defined in Internal Revenue Code Section 152.  Medical Care expenses include expenses for the diagnosis, cure, mitigation, treatment or prevention of disease, as well as for transportation primarily for and essential to this medical care.
2. Tuition and related educational fees for the next 12 months for post-secondary education for the Participant or the Participant’s spouse, child or dependent.  Related educational fees include fees, books, equipment required for and courses of instruction and room and board.
3. Down payment and other costs directly related to the purchase of the Participant’s primary residence (excluding mortgage payments).
4. Payments to prevent the eviction of the Participant from the Participant’s principal residence or foreclosure on the mortgage of the Participant’s principal residence.

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What is a Hardship Withdrawal?

Hardship Withdrawals are only available to active participants that require an immediate and heavy financial need and the hardship withdrawal is in an amount up to the amount of the need.  Specifically, the financial need must be due to any one of the (4) reasons listed above under Hardship Loan (question #5 above) PLUS the following fifth (5^th) reason below:             

5. Payments for burial or funeral expenses for the participant’s deceased parent, spouse, children or dependents.

In addition, the gross amount of a hardship withdrawal must be a minimum of $2,000 and cannot exceed 50% of the Profit Sharing account and may include amounts necessary to pay any federal, state or local income tax or penalties reasonably anticipated to result from the distribution.

A participant also must be a participant in the Plan for a minimum of thirty-six (36) months; AND

Proof of the reason is also required for this type of distribution.

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What is the difference between the Money Purchase account balance and the Profit Sharing account balance?

The Money Purchase account balance is all employer contributions made prior to February 1, 2010 and the Profit Sharing account balance is all employer contributions made February 1, 2010 and thereafter.

• Hardship Loans are only available from the participant’s Money Purchase account balance
• General Purpose Loans are available from both the participant’s MP and PS accounts
• Hardship Withdrawals are only available from the participant’s Profit Sharing Account balance
• Age 59½​  or Older Withdrawals are available from only the Profit Sharing Account balance 

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How can a participant verify if they are eligible to take a withdrawal, Hardship Loan, General Purpose Loan or Hardship Withdrawal and what is required to apply for each benefit?

To determine if you are eligible to withdraw funds based on any of the allowed provisions, please contact the Fund Office @ 708.449.7373 to see what options you are eligible for, and how to apply for each.

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If I defaulted on a Hardship Loan or General Purpose Loan, am I eligible for a loan in the future?

Yes, Participants who have defaulted on a loan MAY be eligible for a new loan if the Participant has repaid the entire loan balance plus any accrued interest. 

Please contact the Fund Office if you believe you might qualify and are interested in taking a future loan from your Annuity account.

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Will my distribution be taxed?

Unless you have requested a Rollover to another qualified plan or to an IRA, the entire gross distribution from your MP or PS sources will be subject to a 20% mandatory withholding for Federal Income Tax.

In addition to being liable for income tax, for withdrawals taken prior to the age of 59½ , a participant may be subject to a 10% early withdrawal penalty under the Internal Revenue Code and may want to consult with a professional tax advisor prior to taking payment of benefits from their account.

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Am I eligible to take a withdrawal of my account upon reaching the age of 59½?

Yes, only active participants are eligible for age 59½ withdrawals from the funds in your Profit Sharing Source only. Funds under the Money Purchase source are not eligible. In addition, this type of distribution is allowed once every six (6) consecutive months.

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Can I stay in the SMW Local 73 Annuity Plan when I retire or change jobs?

Yes!  Many people think that once they retire or stop working for Local 73 employers, they must withdraw their SMW 73 Annuity Plan account.  This is not true!  You can stay invested in the Annuity Plan and continue to receive the following benefits:

• Free retirement guidance
• Continued tax-deferred savings
• Ability to stay invested in plan-specific investment options that can have lower costs
• Account support from Fidelity Representatives

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What is a pension credit?

Pension credits determine the monthly amount of your pension benefit. In general, you earn one pension credit for each calendar year in which you work at least 1,200 hours in covered employment.

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What happens if I don’t work 1,200 hours in a calendar year?

You can still earn partial pension credits. For every 100 hours you work in a calendar year, you will earn 1/12 of a pension credit. For example, if you only work 600 hours in a calendar year, you still earn ½ of pension credit for that year. All of your pension credits (even those fractional ones) will be added together when you retire.

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What is a special service credit?

Special service credits are an additional credit amount you may receive when you work more than the hours needed to earn a full pension credit. You receive a special service credit amount of $5.50 for every 300 hours you work in excess of 1,200 hours in a year (up to 2,100 hours). The special service credit was introduced in calendar year 2000.

For example, suppose you work 1,800 hours in a calendar year. You receive a special service credit of $5.50 for every 300 hours you work past 1,200 in that calendar year. Because you worked an additional 600 hours, your two special service credits total $11.00 ($5.50 for 1,500 hours and $5.50 for 1,800 hours) for the calendar year. The $11.00 is added to the amount of your regular pension credit.

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Can I use my special service credits to be eligible for the Rule of 95 Pension or other types of pensions?

No. Special service credits are used to increase the amount of your pension, but they can’t be used to help you meet the eligibility requirement for a benefit.

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Can I get credit for non-work time?

There are several ways you can get pension credit for non-work time (for example certain periods of worker’s compensation time and short term disability time); however these credits are limited. For more information, please contact the Fund Office.

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What is the current benefit accrual rate?

Effective April 1, 2001, the benefit accrual rate per pension credit is $43.50. This accrual rate generally applies to you if leave covered employment on or after April 1, 2001.

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When Should I Apply for My Pension?

The Effective Date of your pension depends on how quickly you return the Pension Application and all other mandatory pension documents to the Fund Office. No pension benefits will be paid for any period prior to the first day of the month following the month in which you have submitted all of the appropriate documentation to the Fund Office. You must have all necessary supporting paperwork on file within 90 days after the pension application is received by the Fund Office. If you do not have all the necessary supporting paperwork on file within 90 days after the pension application is received by the Fund Office, then the application will be closed and you must re-apply for pension benefits and will be given a new Effective Date.

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What are the eligibility requirements for a Regular Pension?

You are eligible for a Regular Pension if you:

• are 62 or older; and
• have at least 10 pension credits.

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How is a Regular Pension calculated?

A Regular Pension is calculated by multiplying your total full pension credits (based on when you left covered employment) times the benefit accrual rate in effect when you left covered employment. See your Summary Plan Description for accrual rates. This amount may be reduced based on the form of payment you elect.

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How is an Early Retirement Pension calculated?

An Early Retirement Pension is calculated the same as a Regular Pension as if you were age 62. The amount is then reduced by ½% for each full month you are younger than age 62 on the date your pension payments will begin.

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What are the eligibility requirements for an Early Retirement Pension?

You are eligible for an Early Retirement Pension if you:

• are age 55, but under age 62; and
• have earned at least 10 pension credits.

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What is a "Rule of 95" Pension?

You are eligible for a "Rule of 95" Pension if:

• you leave covered employment on or after April 1, 1997; and
• the sum of your age and your pension credits equals 95 or more.

If you qualify for a "Rule of 95" Pension, then you can retire with a benefit that is NOT reduced based on age (Early Retirement Pensions are reduced). For example, if you started working at age 21 and you earned 37 pension credits by the time you were 58, then you can retire at age 58 without a reduction even though you are younger than age 62.

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What are the eligibility requirements for a Normal Retirement Age Pension?

You are eligible for a Normal Retirement Age Pension if you:

• are not eligible for a Regular, Early Retirement, Disability or Deferred Pension; and
• are a participant in the Plan after your normal retirement age.

In general, your normal retirement age is age 65 or the fifth anniversary of your participation in the Plan. If you do not have an hour of work after January 1, 1988, your normal retirement age is age 65 or the tenth anniversary of your participation in the Plan.

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What documents do I need to submit with my pension application?

You will need to provide proof of your age, proof of your spouse's age (if married), and your marriage license (if applicable). If you served in the military, please submit a copy of your discharge papers (DD214). A drivers’ license is not acceptable proof of age. For a list of acceptable proofs, please contact the Fund Office. If you have been married or divorced, please submit a full copy of your divorce decree and marital settlement agreement that includes language regarding your former spouse's right to, or waiver of, a portion of your pension benefit. Failure to do so may delay receipt of your pension benefit.

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I have direct deposit. If I move but my direct deposit information stays the same, do I still need to notify the Fund Office of my new address?

Yes, a current address needs to be on file with the Fund Office for mailing of benefit changes and announcement letters. The Fund Office is constantly sending important information and needs to know when your address changes.

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When can I file for a Disability Pension?

The Trustees are the full and final judges of Total and Permanent Disability and of entitlement to a Disability Pension under the Plan. In order to be eligible for a Disability Pension:

• You must be totally and permanently disabled (as defined in the Summary Plan Description);
• You must submit to an examination by a physician selected by the Board of Trustees;
• You must have at least 10 Pension Credits, including at least four earned during the Contribution Period; and
• You must be actively working as a sheet metal worker at work for which contributions are paid to this Fund. This means you must have earned at least one-half (1/2) Pension Credit in Covered Employment under this Fund within the 12 month period immediately preceding when you became totally and permanently disabled.

It is important that you file an application for a disability pension immediately. There will be no retroactive payments if you file to complete an application on a timely basis.

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Please explain how the Comprehensive Major Medical deductible works. There are five people in my family.

There are 2 types of deductibles within the Comprehensive Major Medical Plan:  the Individual Deductible and the Family Deductible.  The Individual Deductible is $250.  A participant must incur $250 in covered expenses before Comprehensive Major Medical Benefits are payable for that individual. The Family Deductible is met when three (3) of your family members have met their Individual Deductible of $750 during the Calendar Year.  After that, no other covered family members will have to meet the Individual Deductible.

The individual deductible for Plan C participants is also $250.

The individual deductible for participants covered under the Retiree Plan is $350.

The individual deductible for participants covered under Plan A is $250.

The individual deductible for participants covered under the Plan C Non Bargained Plan is $500

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What is the out-of-pocket maximum per year?

After the individual deductible is met, the out-of-pocket maximum is $750 per person each calendar year, for covered expenses. The out-of-pocket maximum is not applicable for covered expenses received at Non-PPO Hospitals or Non-PPO Ambulatory Surgical Facilities or for services received from a Non-PPO physician.

The out-of-pocket maximum for participants covered under Plan A is $750.00

The out-of-pocket maximum for participants covered under Plan C is $1,250.

The out-of-pocket maximum for participants covered under the Retiree Plan is $2,000.

The out-of-pocket maximum for participants covered under the Plan C Non Bargained is $1,750.

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What is my coverage if I have an Emergency appendectomy or accident and I’m hospitalized at Non-PPO hospital?

If you are hospitalized or receive treatment for an Emergency (i.e. a sudden and unexpected onset of a traumatic bodily injury or sickness) at a Non-PPO hospital, you will receive the same coverage as if you were treated at a PPO hospital.

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What coverage do I have for Non-emergency treatment of an illness at a Non-PPO Hospital or for surgery performed at a Non-PPO Ambulatory Surgical Facility?

If you receive treatment for a non-emergency treatment of an illness at a Non-PPO Hospital or surgery at a Non-PPO Ambulatory Surgical Facility, the Plan will pay 70% of the ALLOWABLE CHARGE. In addition, Non-PPO charges do not apply to the out-of-pocket maximum.

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Is there a lifetime maximum benefit?

In general, Comprehensive Major Medical lifetime benefits are unlimited. However, limits or maximums may apply to certain benefits, such as Chiropractic Services, Infertility Treatment and the Hospice Benefit.

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My spouse and I were recently divorced, does she remain covered under the Plan?

Your spouse is not eligible for coverage under the Plan as your Dependent as of the date of your divorce or legal separation. Your spouse may be eligible for continuing coverage for 36 months after the divorce or legal separation under COBRA. To be eligible for COBRA coverage, you or your spouse must notify the Fund Office within 60 days of the divorce or legal separation.

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My son is 22 years old and recently graduated from college. Does he still qualify as my dependent for medical coverage?

Yes. Dependent children are covered up to age 26, regardless of whether they are students, reside with you, and/or are married. Please notify the Fund Office if your dependent is covered by another group health plan as his/her own employer’s insurance is primary.

PRESCRIPTION DRUG BENEFIT

 

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What if I need to start taking a maintenance medication right way?

Ask your doctor for two prescriptions – one for a 30-day supply to be filled immediately at a local pharmacy and a second to be submitted to Express Scripts for a 90-day supply, with appropriate refill instructions.

DENTAL BENEFIT

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My dentist wants to put in a crown. Should my dentist submit a predetermination form to Delta Dental of Illinois?

Yes. The Fund Office wants you to be aware of what benefits will be payable before you have costly dental work done. This way you won’t be surprised by the portion of the bill that is your responsibility.

Plan C participants are not covered under the Dental Plan.

MENTAL AND NERVOUS DISORDERS AND/OR SUBSTANCE ABUSE

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Our doctor recommended a drug addiction treatment program for my son. What coverage is provided for this treatment?

The Plan provides coverage for out-patient or in-patient facility and physician charges for Mental or Nervous Disorders and/or Substance Abuse treatment. To find a PPO Facility or PPO Physician or to find out whether the recommended Provider is in the PPO network, you may contact Blue Cross Blue Shield of Illinois at 1-800-810-2583, visit the Blue Cross Blue Shield of Illinois website at www.bcbsil.com.

 

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My doctor said I should see a therapist for my depression. What coverage is provided for this treatment?

Coverage will be provided for treatment of a mental or nervous disorder if you see a psychiatrist, psychologist, mental health counselor, substance abuse counselor or social worker with a master’s degree or higher.

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My spouse wants to see a marriage counselor. Is coverage provided for this?

No. This type of counseling is not considered outpatient treatment for a mental or nervous disorder. The Plan only covers Medically Necessary treatment. Marriage counseling is not considered Medically Necessary by the Plan.

SKILLED NURSING FACILITY CARE

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My spouse had a stroke. Now that the crisis stage is over the doctor wants to move her to a skilled nursing home. Are Skilled Nursing Homes covered?

If you or an eligible dependent have been hospitalized, you or your dependent may continue recovery as Inpatient in a Skilled Nursing Facility. Services must be received in a Plan/PPO Skilled Nursing Facility. To verify a facility is a Plan/PPO Skilled Nursing Facility, you may contact Blue Cross Blue Shield of Illinois at 1-800-810-2583, visit the Blue Cross Blue Shield of Illinois website at www.bcbsil.com.

ADMINISTRATIVE INFORMATION

 

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I would like to have a copy of all the claims my family incurred during the past year. How can I get copies?

You may access your Claims History and view and print your Explanation of Benefits (EOBs) on this website. Click on the Link to https://memberxg.gobasys.com/SMWL73/main/#!/account/login to view your claims.

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I will be in the area of the office next week and would like to stop by the Fund Office to discuss my claims. Is that o.k.?

Please call for an appointment if you feel a visit to the Fund Office is necessary. This will benefit both you and the Fund Office, since the Fund Office personnel will be able to have your records available at the time of your appointment. They will be able to give your problems or concerns prompt attention.

GENERAL EXCLUSIONS AND LIMITATIONS

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I have multiple sclerosis and my doctor indicated that I might need a wheelchair sometime in the future. Would this expense be covered?

If you need Durable Medical Equipment (DME), you should call Med-Care Management to determine if the expense is covered and if so, if the equipment should be rented or purchased. A physician’s prescription of necessity and the length of time you are expected to need the equipment must be submitted to the Fund Office prior to the purchase/delivery of the item. This Plan will purchase such DME in accordance with the Plan’s coverage of only once in an individual’s lifetime. Please note that repairs of the equipment are not covered by the Plan.

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