UFCW Local 1776 Benefit Funds

Life and Accidental Death and Dismemberment
Life Insurance
The Fund provides life insurance benefits to eligible participants under a policy of insurance with Union Labor Life Insurance Company ("Union Labor Life"). The amount of the benefit depends on your length of service or your position. Your service is calculated based on your years of service from your date of hire. Your dependents are not covered under this benefit.
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If you die, the beneficiary or beneficiaries that you designated on the Fund form designated for this purpose will receive the benefit. You can name one or more beneficiaries, and you can change beneficiaries at any time. Changes to your beneficiary form will be effective upon receipt of the change form by the Fund Office. If you have any change in circumstances, such as a divorce, you should consider changing your beneficiary designation on the Fund beneficiary designation form to ensure that the life insurance benefits are paid in accordance with your wishes. If your named beneficiary dies before you do, his or her share will be divided equally among the remaining beneficiaries, unless you have indicated otherwise on the Fund’s form.
If no beneficiary is named, or if no named beneficiary survives you, Union Labor Life may, at its option, pay:
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your surviving spouse;
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your surviving children;
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your surviving parents;
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your surviving siblings; or
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the executors or administrators of your estate;
If the participant’s beneficiary is a minor or incompetent, Union Labor Life has the option of paying this insurance in monthly installments to the person who cares for and or supports the beneficiary.
Upon your death, the Fund will review your most recent beneficiary designation form to ascertain your named beneficiaries, if any, and will forward a Union Labor Life claim form to such named beneficiaries. Upon receipt of the completed claim form and supporting documentation (i.e., death certificate) from your beneficiary, the Fund will forward these documents to Union Labor Life for review. If any dispute arises as to the appropriate beneficiary for your life insurance benefits, Union Labor Life will make the final determination.
Accidental Death and Dismemberment
The Fund also provides eligible participants with Accidental Death & Dismemberment (“AD&D”) benefits under a policy of insurance with The Union Labor Life Insurance Company (“Union Labor Life”). The amount of your coverage depends on your life insurance amount, and the extent of your injury in the case of accidental dismemberment. Your dependents are not covered under this benefit.
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You will receive AD&D benefits if you suffer a loss (see list below) due to an “accidental injury,” as defined below. For purposes of AD&D benefits, “injury” means a bodily injury that results directly from an accident, is independent of all other causes, and occurs while you are eligible for this benefit under the Fund. An injury does not include any loss resulting from sickness or disease or from medical or surgical treatment of a sickness or disease.
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If you sustain an injury which results in any of the following losses within 90 days of the date of accident, Union Labor Life will pay you (or your beneficiary, if you die) a percentage of your Basic Benefit Amount, as indicated below. For covered multiple losses due to the same accident, Union Labor Life will pay only for that loss for which the largest amount is payable.
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For loss of:
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Life: 100%
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Two hands: 100%
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Two feet: 100%
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Sight of two eyes: 100%
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One hand and one foot: 100%
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One hand and sight of one eye: 100%
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One foot and sight of one eye: 100%
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One hand or one foot: 50%
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Sight of one eye: 50%
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Four or more fingers (one hand): 50%
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Thumb and index finger (one hand): 25%
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Speech and hearing (both ears): 100%
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Speech or hearing (both ears): 50%
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Loss of:
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a hand or foot means complete severance at or above the wrist or ankle joint;
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sight means irrecoverable and complete loss of sight in the eye;
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speech or hearing means the entire and irrecoverable loss of speech or hearing, as certified by a Diplomate of the American Board of Otolaryngology;
except as excluded under the Exclusions in the Accidental Death and Dismemberment section of the SPD.