1295 Butterfield Rd., Aurora, IL 60502-8879 Ph (630) 978-4600 
 Fax (630) 978-4616     benefitinfo@nibf501.org
 

 

 

 

 

 

 


Your Privacy  *

Forms

Eligibility

Announcements

Updates

Trustees

Providers

Schedule of 
Benefits 

Summary Plan  Description * 

Summary Annual  Report *

Tips for 
Filing a Claim

FAQ's

Total Wellness *

 

                           HEALTH AND WELFARE FUND

Quick View of Your Benefits

Medical Benefits

  • The Northern Illinois Benefit Fund uses Blue Cross Blue Shield of Illinois to provide the members with their hospital and doctor PPO Network. 
  • As of January 1, 2003, the network expanded to include Blue Cross Blue Shield PPO providers across the entire United States. 
  • Effective January 1, 2004, the Plan requires preauthorization for any hospitalizations or surgery. The Fund uses Med-Care Management for the Medical Review Program. 
  • Referrals to a specialist are not required.  
  • Use of a Blue Cross Blue Shield PPO physician or hospital is not required; a member can see any physician or use any hospital facility that he chooses. 
  • The plan has a $200 individual/$600 family calendar year deductible for PPO providers and a $300 individual/$900 family calendar year deductible for non-PPO providers. 
  • Once the deductible has been met for PPO providers, bills are paid at 80%.  Bills are paid at 60% for non-PPO providers.
  • The out-of-pocket amount for PPO providers is $1,500 individual/$3,000 family and $3,000 individual/$4,000 family for non-PPO providers. 
  • When the out-of-pocket limits have been met for the calendar year, bills are paid at 100% for the remainder of that calendar year to a lifetime maximum benefit of $2,000,000. 
  • Blue Cross Blue Shield of Illinois providers can be viewed on the Blue Cross Blue Shield of Illinois website at www.bcbsil.com. 

back to top

Dental  Benefits

  • Delta Dental of Illinois administers the dental benefits for the Northern Illinois Benefit Fund.  

  • Delta Dental has two provider networks. 

  •  If a dentist is a member of the DeltaPreferred network, the calendar year maximum benefit per family member is $1500.  

  • If a dentist is a member of the DeltaPremier network, the calendar year maximum benefit per family member is $1250.  If a dentist does not participate in the Delta networks, the calendar year benefit per family member is $1000.

  • Routine care is paid at 100% and restorative services are paid at 80% under all three benefit plans.  Orthodontic coverage is available to dependent children through the 19th birthday. 

  •  Providers in both the DeltaPreferred and DeltaPremier networks can be viewed at  www.deltadentalil.com.

back to top

Vision  Benefits

Vision Service Plan administers vision benefits. The Plan provides for a free vision exam, lenses and frames every 12 months for the member and his dependents if visiting a Vision Service Plan eye doctor. Providers in the Vision Service Plan network can be viewed at www.vsp.com.

back to top

Prescription Drug Program

Prescription drugs are purchased through the Caremark Prescription Drug program.  Short-term prescriptions are purchased at retail pharmacies with a drug card.  The member pays $5.00 min./10% for generic drugs or $10 min./10% for brand name drugs.  Maintenance medications are purchased through the mail for a $15 co-payment for a 90-day supply of generic drugs and a $30 co-payment for a 90-day supply of brand name drugs. The Caremark website can be viewed at www.caremark.com.

back to top

Life Insurance/Accidental Death and Dismemberment

Once the member has gained initial eligibility for benefits, he is entitled to a $20,000 life insurance benefit payable to the beneficiary of his choosing.  There is an additional $20,000 payable if the death was accidental.  The Retiree life insurance benefit is $5,000.

back to top

Disability

If a member is totally disabled due to a non-occupational illness or injury, he is entitled to a $350 per week disability benefit for up to 26 weeks.  Benefits begin on the first day of disability for injury or hospital confinement and the eighth day for an illness.  Disability hours are credited so that Health & Welfare eligibility is not lost due to disability.   If a member is totally disabled due to an occupational illness or injury, he is credited with disability hours for up to 26 weeks so that he does not lose Health & Welfare eligibility.

back to top

Retiree Insurance

EARLY/DISABLED RETIREES (Under Age 62) - If you were covered under the Plan as an active bargaining unit or Class A non-bargaining unit employee, you must meet all of the following eligibility requirements in order to be eligible for Retiree Benefits for yourself and any dependents:

  1. You must be retired from work with all contributing employers.

  2. You must be receiving early retirement or disability pension benefits from the Pension Fund.

  3. You must have been covered under the Northern Illinois Benefit Fund as an active eligible employee during the 5 years (60 consecutive months) immediately prior to retirement.

  4. You must have a minimum of 10 years of service in the industry during you lifetime.  (The 10 years of service in the industry can include the 5 years of immediate past coverage.)

  5. You must make correct and on-time self-payments to the Fund.

When you become age 62, and if you meet the 10-year immediate past coverage requirement, you will no longer be required to make self-payments for Retiree Benefits for yourself and your spouse.  If you want to cover your dependent children, you must continue to make self-payments for their coverage.

NORMAL RETIREES (Age 62 and Over) - If you are a normal bargaining unit retiree, you must meet all of the following eligibility requirements in order to be eligible for Retiree Benefits for yourself and your dependent spouse:

  1. You must be retired from work with all contributing employers.

  2. You must be at least 62 years old.

  3. You must have been covered under the Northern Illinois Benefit Fund as an active eligible employee during the 5 years (60 consecutive months) immediately prior to retirement.

  4. You must have a minimum of 10 years of service in the industry during your lifetime.  (The 10 years of industry service can include the 5 years of immediate past coverage.)

  5. You must be receiving normal retirement pension benefits from the Pension Fund.

No Self-Payments if you meet 10-Year Immediate Past Coverage Requirement - If you meet the normal retirement eligibility requirements above, you do not have to make self-payments for Retiree Benefits after age 62 if you were continuously eligible under the active employee benefits of the Plan for the full 10-year period immediately preceding your retirement.

If you are an early retiree, you must make self-payments for Retiree Benefit coverage until you become age 62.  At that time, you will no longer have to make self-payments for you and your spouse if you meet the 10-year immediate past coverage requirement.  Otherwise, you must continue to make self-payments after you reach age 62.

If a member will not have 10 years of continuous eligibility at age 62, he may self-pay for the same benefits provided to active members for the remainder of his (and his spouse’s) life with a rate reduction once he reaches the age of 65 and is on Medicare, if he has five (5) consecutive years of eligibility immediately prior to retirement and ten (10) years of service in covered employment during his lifetime.           

back to top     

*In order to view these documents you must have Adobe® Acrobat® Reader. If you do not have this software, you can download it for free from Adobe's Web Site.
 
 
 

This site as last updated : 11/11/08

Please contact the webmaster with any questions or comments

Plumbers and Pipefitters Local 501
Northern Illinois Benefit Funds
1295 Butterfield Rd., Aurora, IL 60502-8879
Ph (630) 978-4600 Fax (630) 978-4616