Health Welfare Fund It s tIme to make an electIon by ramhood17


									           Health & Welfare Fund

HealtH Coverage
It’s tIme to make an electIon!

2008 onlIne electIon GUIDe
                                                  It’s tIme to make an electIon
                                                  The time has come for you to make your health coverage election and
                                                  authorize your weekly pre-tax payroll deduction. This means you will
                                                  have to:
                                                  ■ Elect the health coverage level that is right for you and your family.
                                                  ■ Add or remove dependents from coverage.
                                                  You are encouraged to complete your election online in order to
                                                  confirm continuation of health coverage for 2008. The open enrollment
                                                  election period is January 2, 2008 to February 15, 2008. The election
                                                  you make will be effective March 1, 2008 and continue until
                                                  December 31, 2008.

IN THIS GUIDE                                     Note: If you do not have access to a computer or the Internet, you must
                                                  complete and return a 2008 Health Coverage and Payroll Deduction
About This Guide ......................... i      Authorization Form to the Fund Office by February 15, 2008. Forms are
                                                  available at the Fund Office.
Bringing Online                                   Whether you make your election online or complete the form, you need
Communications                                    to do so by the election period deadline in order to continue coverage
to Participants..............................1    in 2008.

Health Coverage Levels ............1
                                                  about thIs GuIde
Your Weekly Pre-Tax                               The 2008 Online Election Guide is designed to help you make your
Payroll Deduction .......................2        health coverage election and to help you complete the online election
                                                  process. You will find information regarding:
Online Election Instructions ...3                 ■ The new online election process
Other Important                                   ■ Your health coverage levels
Information...................................6   ■ Weekly pre-tax payroll deduction
                                                  ■ Instructions for making your health coverage election online
                                                  ■ What to do if you don’t have computer access
                                                  ■ Election checklist and annual reminders
                                                  Please be sure to review this 2008 Online Election Guide carefully
                                                  so that you fully understand your health coverage election and the
                                                  election process. Remember, you must complete your election by
                                                  February 15, 2008.
                                                  If you have any questions during the election process regarding coverage
                                                  levels, weekly pre-tax payroll deductions, or making your election online,
                                                  contact the Fund Office at (413) 733-0177 (or toll free at 800-634-2700).

Questions?                                         election Period: January 2, 2008 – February 15, 2008
                                                               To make your election during this period,
Contact the Fund Office
                                                           log on to Don’t forget,
at (413) 733-0177 (or toll                               you must first register in order to access the Web site.
free at 800-634-2700).

        2008 Election Guide
brInGInG onlIne communIcatIons to our PartIcIPants
We have developed a Web site where you can make your health coverage election. This new Web site is designed to
make your election easier. Through the Web site, you can:
■ Review and update your personal and dependent information.
■ Choose your health coverage level or waive coverage.
■ Add and/or delete coverage for your eligible dependents for 2008.
The Web site is available 24-hours a day throughout the election period. Step-by-step instructions on using the Web
site begin on page 3 of this Guide.
You can make your online election at any computer with an Internet connection. This “anywhere access” is one of the
best features of the online election process—you and your family can review your health coverage options for 2008,
make your benefit decision together, and then make your election.

If You Do not Have a computer with Internet access                                 If you are a first-time computer
We realize that not everyone has a computer or access to the Internet,             user, novice Internet user, or you
therefore, you may complete a 2008 Health Coverage and Payroll                     would just like some extra help,
Deduction Authorization Form available at the Fund Office. If you decide           you can contact the Fund Office
to complete the form, the Fund Office must receive your form no later              at (413) 733-0177 for assistance.
than February 15, 2008.

Your health coveraGe levels
During the election period, you must elect the level of health coverage and authorize the appropriate pre-tax payroll
deduction you want for 2008. Your health coverage includes medical, dental, prescription drug and vision benefits.
Your health coverage level options are:

                                                                             Weekly Pre-tax
                                      coverage level                        Payroll Deduction
                      Full-time employee only                                     $5.00
                      Full-time employee plus spouse                             $10.00
                      Full-time employee plus child(ren)                         $10.00
                      Full-time employee plus family
                      (spouse and child(ren))
                      Waive coverage                                               $0.00

Dependent eligibility
Only your dependents who meet the Plan’s definition of eligible dependents may be enrolled. When you enroll a
dependent online, the Fund Office may contact you and request documentation to verify that your dependent(s)
meets Plan requirements. For example, if you are enrolling a dependent child that is older than 19, you will be
required to provide proof of your child’s full-time student status each semester. For a complete description of eligible
dependents under the Plan and whether your dependents are eligible for coverage, please refer to your Summary Plan
Description, or contact the Fund Office for more information.

                                          UFCW Local 1459 and Contributing Employers Health & Welfare Fund              
If Both You and Your spouse are employees
If you and your spouse are both eligible for benefits from the Plan, you will need to consider which level of coverage
will best meet your needs. If you are not sure what health coverage level to choose, you may contact the Fund Office
for more information.

Your WeeklY Pre-taX PaYroll deductIon
Beginning March 1, 2008, you will be required to contribute toward the cost of your health coverage. The health
coverage level you choose determines your weekly pre-tax payroll deduction as outlined under Your Health Coverage
Levels. The amount is $5 (employee only), $10 (employee plus spouse), $10 (employee plus child(ren)), or $15
(employee plus family coverage).
When you authorize a weekly pre-tax payroll deduction for your health coverage, that amount is deducted from your
paycheck on a pre-tax basis. This means that the money comes out of your paycheck before federal, Social Security
and most state income taxes are withheld, thus lowering your income for tax purposes and increasing your take-
home pay, as compared to an after-tax deduction.
Below is an example of the impact of a pre-tax payroll deduction versus an after-tax payroll deduction.
Note: This example assumes a total tax rate of 25% and an “employee + family” coverage election. Only you and your
tax preparer can determine your tax debt and the actual value to you of any pre-tax deduction.

                                                                     Pre-tax Payroll                    after-tax
                      tax savings example                              Deduction                    Payroll Deduction*
              Annual earnings                                           $24,000                          $24,000
              Annual pre-tax payroll deduction
              ($15/week family coverage)                                   $780                                 $0
              Taxable earnings                                           $23,220                           $24,000
              estimated taxes at 25%                                     $5,805                            $6,000
              After-tax earnings                                         $17,415                           $18,000
              Annual after-tax payroll deduction                              $0                             $780
              In your pocket                                            $17,415                           $17,220
             * Note: After-tax amounts are shown for comparison purposes only—an after-tax payroll deduction is not available.

A pre-tax payroll deduction is not subject to Social Security taxes, therefore, the amount you may receive in Social
Security benefits may be reduced. This is because final Social Security benefits will be based on your reduced earnings
(gross pay less pre-tax payroll deductions). For most employees, any future reduction in Social Security benefits is
insignificant compared to the value of paying lower income taxes and increasing your take-home pay today (refer to
tax savings example above).

making changes During the Year
With a pre-tax payroll deduction, the IRS limits when you can make changes to your coverage election outside of the
open enrollment election period, unless you have a qualifying event during the year. There are two provisions that
allow for changes during the year—IRS qualifying life events and Special Enrollment Rights under HIPAA.

       2008 Election Guide
The IRS requires that benefits paid with pre-tax dollars stay in effect through the full Plan year. Therefore, once made,
you cannot change your election unless you have a qualifying event. This means you cannot decide during the year
that you want to change coverage levels simply because you would like lower-cost coverage or wish to stop coverage
altogether. You must experience a qualifying life event as noted below. A complete list of what the IRS considers a
qualifying event is listed in your Summary Plan Description, but in general, they include:
■ a change in your marital status
■ the birth or adoption of a child
■ a dependent’s loss of eligibility (e.g., because he/she reached the age limit for coverage)
■ death of a dependent
■ a change in your spouse’s eligibility for coverage
The Special Enrollment Rights under HIPAA allows for enrollment during the year if you decline coverage now
because you and your dependent(s) are covered by another health insurance or group health plan and you and your
dependents lose eligibility for that other coverage. In addition, if you have a new dependent(s) (as a result of marriage,
birth, adoption, or placement for adoption), you may be able to enroll yourself and your dependent(s).
Any change in coverage must be consistent with the life status change or change as a result of your Special Enrollment
Rights under HIPAA. Any changes must be made within 30 days of the qualifying event. To do so, contact the Fund

onlIne electIon InstructIons
This section guides you in completing your election through the online system. It outlines the choices you need to
make during the open enrollment election period and the actions you should take while using the system.
As you use the system for the first time, be sure to refer to this information. If you need assistance or have questions
about using the system, call the Fund Office at (413) 733-0177.

making your election online is easy.
                                                                           Important Information to Have
Follow these steps.                                                        available During the election Process
                                                                           You should have the following information
1. Find a computer with a connection to the Internet                       with you when you log on to the Web site
You need a computer with a connection to the Internet to complete          and make your health coverage election.
your election online. If you do not have access to an Internet-            1. This election guide.
connected computer at home, other alternatives are available:
                                                                           2. Your Social Security number.
Public Library: Most public libraries provide free access to
                                                                           3. Your spouse and/or dependents’ Social
computers with Internet connections. Check with your local library            Security number(s) and dates of birth.
for hours and information on using computers.
                                                                           4. Your spouse and/or dependents’
Family Member or Friend: If a family member or friend has a                   employer information, if applicable.
computer with Internet access, you may want to see if you can use
                                                                           5. Your spouse and/or dependents’
it to log on and make your elections.
                                                                              other health coverage information, if
                                                                           6. Your e-mail address (to establish your

                                          UFCW Local 1459 and Contributing Employers Health & Welfare Fund             
2. Go to the Fund’s
Enrollment Web site
Once you have access to an Internet-
connected computer:
■ Start the Web browser.
■ Go to
  (type this into the browser’s address bar).
The Web site is available 24-hours per day,
7 days per week.

3. Register
As a first-time user, you will need to register
and set up a Username and Password. Once
you establish your Username and Password,
you will be able to access the system any time
using your log in information.
To register, complete the required personal
information on the Registration page and
answer a Security question. Note: You will
need an e-mail address (which will be your
Username) in order to register, as confirma-
tions will be sent to you through e-mail. If you do not have an e-mail address, you can go to an e-mail service provider
(such as Hotmail or Yahoo!) to set up a free e-mail account.

  a note about Privacy and security
  UFCW Local 1459 and Contributing Employers’ Health & Welfare Fund is dedicated to protecting your privacy
  online. To lessen the likelihood of unauthorized access, maintain data accuracy, and ensure the correct use of
  information, we have put in place reasonable physical, technical, and administrative procedures to safeguard and
  secure the information we display and collect on the Web site. When necessary, we may update such technology
  and procedures to address new vulnerabilities, which may require your cooperation in accessing your account.
  However, technology and security are constantly evolving and new methods of intrusion and interference are
  being used every day. You are the first and most important defense for the security of your private information.
  The secure sections of the Web site contain personal information about you, your spouse, and your eligible
  dependents, including protected health information. All users are required to register and log in using a password.
  If you access the secure sections of this Web site, you understand that your password is intended to protect your
  privacy and should be kept confidential. You are responsible for access and use of information relating to you by
  anyone you authorize, or to whom you disclose your password. Please do not share or disclose your password
  or other personal information with anyone who does not need to use it. Unauthorized entry to the password
  protected section of this site, or misuse of the information contained in these sections, may be pursued and
  prosecuted to the fullest extent permitted by law.

       2008 Election Guide
  the Way We Use Your Information
  We use the information that you provide about yourself, your spouse, and your eligible dependents only for
  purposes of providing health coverage. We do not share this information with outside parties except to the extent
  necessary to provide you with health coverage.
  Should you have other questions or concerns about these privacy policies, please contact the Fund Office.

Your Username
                                                                    Don’t have an e-mail address? You can go to
Your e-mail address will be your Username, so you must have         a free provider such as Hotmail (
a valid e-mail address to log in after you register.                com) or Yahoo! ( to set one up.

Your Password
You will also need to establish a password, which protects you from anyone else gaining access to your personal
information. Your password can be between six and ten characters (any combination of letters and numbers).
The password you choose will not be case sensitive, meaning that if you create your password in all UPPER CASE
LETTERS and enter your password when you log in as lower case letters, you will still be able to log in.

Your Social Security Number
You will need to enter your Social Security number for identification purposes. Your Social Security number will be
encrypted, or scrambled, and unreadable to others. You only have to enter your number once during this process.

A Security Question
To further protect you and your personal information, you will need to answer a security question from a choice of
questions in a drop down list. Once you choose the question, enter your security answer. If you forget your password,
you will need to answer the security question before any information can be released.

4. Enter your 2008 Health Coverage Election
Once you have registered, you will be directed to the Health Coverage Election Period Is Open page. Review this page,
then click “Continue” at the bottom of the page. From there, continue through the pages and enter your information
as necessary.
Note: At any time, you may save your information and log out. Keep in mind that saving and logging out does not
complete the election process. You will need to log back in to complete and submit your election and authorize your
weekly pre-tax payroll deduction.
Personal Profile: Review your contact information listed on this page. You may make changes to your contact
information by visiting Questions regarding the Ahold USA HR Express Web site should
be directed to their Customer Service Center at 800-246-5334. If you do not have a computer with Internet access,
contact your store management to make changes to your personal information.
Make Your Health Coverage Election: This is where you will select the level of coverage that is right for you, your
spouse and your family; or you may waive coverage. Remember, if you waive coverage now, you will not have another
opportunity to make an election until the next open enrollment election period unless you have a qualifying change
in status or Special Enrollment Right under HIPAA (see page 3 of this Guide).
Spouse and Dependent(s) Profiles: If you elected to cover your spouse and/or eligible dependent children, you will
now need to provide additional information about them. Be sure to review the information currently on file with the
Fund Office and make any updates as necessary.
Reminder: You may be required to provide proof of your spouse’s or dependent’s status to the Fund Office. If this is
necessary, the Fund Office will contact you.

                                         UFCW Local 1459 and Contributing Employers Health & Welfare Fund              
In addition to updating your spouse and/or your dependent(s) information, you will also need to indicate whether
they are employed and if they have other health coverage. If this is the case, you will need to enter their employer and
other health coverage information.
Review Your Health Coverage Election: This page will outline the level of coverage you chose and the dependent(s)
you are covering. If you need to make a change, simply click “Go Back” to return to previous screens and make
a change. If the information outlined on the review page is correct, click “Complete” to acknowledge the health
coverage election and authorize your employer to withhold the corresponding weekly pre-tax payroll deduction.
Health Coverage Election Confirmation: This page will tell you that your health coverage election is complete along
with a few reminder messages. You can print this page and keep it for your records.
Note: Even if you make your election and receive confirmation, you can still access the Web site to make a change
provided you do so before the open enrollment election period deadline – February 15, 2008. Remember, if you do
log in and make a change, be sure to complete the necessary screens and again authorize your election and weekly
pre-tax payroll deduction in order for the change to take effect. Then, print out your new confirmation for your
If you have any questions, please contact the Fund Office at (413) 733-0177.

other ImPortant InformatIon
Confidentiality of Your Protected Health Information. Privacy rules, part of the Health Insurance Portability and
Accountability Act (HIPAA) passed by Congress in 1996, became effective for most health care entities on April 14,
2003. HIPAA privacy rules apply to those who provide medical services, such as hospitals and doctors, and also
to HMOs, insurance companies, and health plans. These rules are intended to protect your personal information
from being inappropriately disclosed. They also give you additional rights concerning your health care information.
The UFCW Local 1459 and Contributing Employers Health & Welfare Fund Plan’s statement is available upon request
from the Fund Office.
Women’s Health and Cancer Rights Act of 1998 (WHCRA). As required by this Act, if the Plan provides
benefits to an individual in connection with a mastectomy, the Plan will also provide benefits to that individual for
reconstruction of the breast on which a mastectomy is performed, reconstructive surgery on the other breast to
achieve a symmetrical appearance, prostheses and physical complications for all stages of a mastectomy, including
Notice of Prescription Drug Creditable Coverage. If you are covered under the UFCW Local 1459 and Contributing
Employers Health & Welfare Fund, you have prescription drug coverage that is, on average, as good as standard
Medicare Prescription Drug Coverage.
The Plan is required to provide all Medicare-eligible covered individuals with a Notice of Prescription Drug
Creditable Coverage. If you are eligible for Medicare and have not received a copy of this Notice, please contact the
Fund Office.
The information in this Guide is only a brief summary of certain features of the UFCW Local 1459 and
Contributing Employers Health & Welfare Fund. Full details are contained in the documents that establish the
Plan provisions. If there is a discrepancy between the wording here and the documents that establish the Plan
provisions, the document language will govern. The Trustees reserve the right to amend, modify, or discontinue
all or part of the Plan at any time.

                                                                 UFCW Local 1459 and Contributing Employers
                                                                                      Health & Welfare Fund
                                                                                             33 Eastland Street
                                                                                  Springfield, MA 01109-2348
                                                                       (413) 733-0177 or toll free at (800) 634-2700

       2008 Election Guide

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