Important Documents
Important Forms
Directions: These PDF files require Adobe Acrobat Reader. To download Acrobat click on the button below.
Windows (to save to hardrive):
RIGHT CLICK on the "Win: Right Click..." link below.
Choose either "Save Target As" or "Save Link As"
Choose the location on your hard drive where you wish to save the image and click save.
Macintosh (to save to hardrive):
CLICK AND HOLD or CTRL+CLICK on the document link.
Choose either "Save This Link As" or "Download Link to Disk"
Choose the location on your hard drive where you wish to save the image and click save.
Are my expenses limited?
Once your payments toward the deductible and copayment for eligible medical charges reach the annual out-of-pocket maximum for the individual ($5,000) or family ($10,000), the Plan will usually pay 100% of most eligible expenses for the rest of the calendar year. Expenses not covered under the Plan do not apply toward the out-of-pocket maximum. In addition, some expenses are never paid at 100%.
The Iron Workers Tri-State Welfare Fund is designed to help members and their eligible dependents afford proper health care. The Fund also provides members with disability, life, and accident insurance coverage.
Contributing employers pay the full cost of the Fund and make all contributions. Employee contributions are neither required nor allowed (except for self-payments). Employer contributions are based on the rate(s) specified in applicable collective bargaining agreements.
If you work under the jurisdiction of Iron Workers Tri-State Welfare Fund and your employer contributes to the Fund on your behalf, you are eligible for Plan benefits the first day of the month after you accumulate 500 hours within a nine-month period. Once you meet the initial eligibility requirements, to maintain eligibility, you will need to accumulate at least 350 contribution hours in each eligibility quarter. For more information on eligibility, click here.
If you need to add a dependent, please complete the Dependent Addition Form (PDF, 55K) and send or fax it to the Fund Office. See Definition of Eligible Dependent Child.
If your dependent no longer meets the definition of a dependent, for example, if you divorce or your child reaches the limiting age, you have up to 60 days following the event to notify the Fund Office in writing of the status change. If you do not notify the Fund Office in 60 days, your dependent may not be eligible for COBRA continuation coverage.
The Fund’s medical coverage can help you and your family get and stay well. For most medical benefits, you or your family must meet the calendar year deductible before the Plan pays benefits. Once you meet the deductible, benefits depend on whether you go to in-network or out-of--network providers for your care. View the Schedule of Benefits. Here are the choices:
Go to the Healthy Foundations page to see how you can get up to $400 to pay for healthcare expenses and the programs available to keep you and your family as healthy as possible.
The Plan pays for prescription drugs after you pay a small copayment per prescription through a Express Scripts participating retail pharmacy or through the Mail Order Program. For more information on prescription drug coverage, click here.
If your employer provides dental coverage, you can visit any dentist to help you and your family take care of your teeth. The Plan pays a percentage of the scheduled amount for Eligible dental expenses limited to a $1,000 per person each calendar year maximum (orthodontia has a $1,000 lifetime maximum). Preventative expenses for children younger than age 19 are not subject to the $1,000 limit. Click here for more details about dental benefits.
If your employer provides vision coverage, you can receive reimbursement for eye examinations, lenses, and frames for up to $200 per person each calendar year. Preventative expenses for children younger than age 19 are not subject to the $200 limit. Click here for more details about vision benefits.
If you die, the Plan will pay a Life Insurance Benefit of $10,000 to your beneficiary. Be sure your beneficiary designation is up-to-date. To change your beneficiary, complete the Beneficiary Designation form and return it to the Fund Office. If you need to make a claim, call the Fund Office. If your covered dependent dies, you will receive a Dependent Life Insurance Benefit of:
| Spouse: | $2,500 |
| Child: | $2,500 |
If you are an active employee covered under the Fund, the Plan pays you $5,000 to $10,000 if you are seriously injured in an accident. The amount depends on the severity of the accidental loss. To submit a claim, call the Fund Office for a claim form.
If you are unable to work due to a non-occupational illness or injury for more than seven consecutive days for an illness from the first day or if you are injured, you may receive a weekly benefit from the Plan of $250 for up to 26 weeks. Click here for details. To submit a claim, complete the Disability Claim form (PDF, 70K) and return it to the Fund Office.
If you are eligible for the Pre-Funded Retiree Allowance, the Fund will contribute toward your retiree health coverage. The amount of the Fund's contribution will be based on your years of service and the coverage options you choose. For more information about the Pre-Funded Retiree Allowance, click here.