The Sheet Metal #10 Benefit Fund - Active Members

 

The Sheet Metal #10 Benefit Fund is a self-funded health plan that provides medical, prescription, dental, short term disability etc coverage for participants and their dependents.


How do I become eligible:  (Initial first time eligibility) 

If you are a brand new participant in the plan, then you will become eligible for health benefits the 1st of the 2nd month after you have worked 8 hours in a classification that requires contributions to the plan. For example, 8 hours worked in January will give you March 1st coverage.

It is important to note that if you lose eligibility you do not regain eligibility immediately upon your return to work.  Nor under the Initial Eligibility rates indicated above.


Non-bargained employees should contact their employer or the Benefit Office at: (651) 770-0991 or (800) 396-2903.


How do I requalify for health coverage:  (Requalifying eligibility) 

Re-qualifying participants will become eligible for health benefits the 1st of the third month following when your employer reports 145 hours in a classification that requires contribution to the plan.  In other words, the hours you may work in April do not actually dictate eligibility until July coverage.  Please keep this in mind when making decisions about your health coverage.  Please note: there are special rules for re-qualifying if you have worked at least 80 hours, which will allow you to self pay the difference between the contributions paid and the full cost of coverage.  


Non-bargained employees should contact their employer or the Benefit Office at: (651) 770-0991 or (800) 396-2903.


How do I maintain eligibility:  

Once you meet the Initial or Requalifying eligibility requirements, you will fully maintain coverage if your employer(s) remit a total of 145 hours in the applicable work month.  There is a two (2) month lag in your eligibility.  In other words, the hours you work in April don't actually dictate eligibility until July coverage.


Who do I call if I have questions about eligibility or an insurance claim:   Please contact the claims administrator

   

WILSON MCSHANE 

PO BOX 9474 

Minneapolis, MN 55440-9474 

Office: (952) 854-0795  Toll Free: 1 (800) 535-6373  Fax: (952) 854-1632  

Office Hours:  Monday through Friday 8:00 a.m. - 5:00 p.m.


What services are covered by the Plan?  

Please contact Wilson McShane our Claims Administrator or review the Summary Plan Description and Summary Material Modications provided below.  It is very important to review both documents. 

To find a participating Blue Cross and/or Blue Shield Provider:

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Please click here for Instructions for finding a Blue Cross Blue Shield Provider:  Instructions to Find a BCBS Provider.pdf



Please review the Summary Plan Description and Summary Material Modifications for information regarding rules and coverage for the health plan.

Please click here for the Summary Plan Description for both Plan A & B Participants:  Summary Plan Description.pdf 

(The Summary Plan Description provides a detailed description of the eligibility requirements for coverage and the benefits provided through the health fund.  If you view this document make sure you also review the Summary of Material Modifications provided below)


Please click here for the Summary Material Modifications for Plan A:    Summary Material Modifications Plan A.pdf

(The Summary of Material Modifications include any changes made to the Plan since the Summary Plan Description was last printed)


Please click here for the Summary Material Modifications for Plan B:  Summary Material Modifications Plan B.pdf

(The Summary of Material Modifications include any changes made to the Plan since the Summary Plan Description was last printed)