The Plumbers Local Union No .1 Welfare Fund understands that a premier benefits package is critical to you and your family. This section of the web site contains information about a number of benefits and programs available to enable you to access quality health care, provide for your financial security and the security of your family, and maintain a healthy lifestyle. It's important that you get familiar with your Plumbers Local Union No. 1 Welfare Fund benefits right away because you will need to make some important benefits decisions and return your completed enrollment form.
If you do not submit your elections your eligible dependents will not be enrolled in the plans and will not be eligible for coverage until a completed enrollment form is received and processed by the Fund.
To learn about your Welfare Benefits:
If you have questions after your review of the benefits information in the SPD and SMM’s, please contact the Plumbers Local Union No. 1 Welfare Fund at 718-223-4313. You may also make an appointment with a representative of the Welfare Fund at the Fund Office at 50-02 Fifth Street, 2nd Floor, Long Island City, New York 11101. Hours: 8 a.m. to 4:30 p.m., Monday through Friday.
Eligibility for benefits from the Plumbers Local Union No. 1 Welfare Fund is based upon hours worked under Collective Bargaining Agreements which obligate employers to report and pay contributions to this Fund on behalf of Employees.
An Employee will be eligible for benefits from this Plan as an Active Eligible Employee on the first day of the calendar month following three (3) consecutive months of Covered Employment with contributing Employers in which the Employee is credited with at least 290 hours in Covered Employment under this Plan or the Prior Plans. You should keep track of the hours you work each month.
Once an Employee becomes eligible for benefits, certain of his or her Dependents may also become eligible for benefits from this Fund.
Each Eligible Dependent must be listed on an Enrollment Form signed by the Employee and filed with the Fund Office. Each change in Dependent Enrollment (adding or terminating a Dependent) after the initial enrollment must be submitted with evidence or proof of Dependent status satisfactory to the Trustees. If there is a change in the Employee’s marital status, such as divorce or legal separation, the Employee is responsible for notifying the Fund Office immediately. Any benefits paid on behalf of a divorced Spouse or stepchild who no longer lives with the Employee after the date specified in the legal document is the responsibility of the Employee or the former Spouse.
Should you need emergency care, your Plan is there to cover you. Emergency care is covered in the hospital emergency room. To be covered as emergency care, the condition must be one in which a prudent layperson, who has an average knowledge of medicine and health, could reasonably expect that without emergency care, the condition would:
- Place your health in serious jeopardy
- Cause serious problems with your body functions, organs or parts
- Cause serious disfigurement
- In the case of behavioral health, place yourself or others in serious jeopardy.
Emergency Room Hospital charges for an accident or a sudden and serious illness will be paid in full after a $250 co-payment if Medically Necessary. Charges are waived if you are admitted within 24 hours. If it is determined that the services provided are not considered an emergency, deductible and coinsurance will apply. Fees for services by a non-participating Physician in connection with an Emergency Room visit are paid in full through your POS.
The Plan covers professional ground only ambulance services when used to transport a patient from the place where an injury occurred, or where the patient became incapacitated due to a disease, to the nearest Hospital where appropriate treatment can be provided.
If you have an emergency outside the United States and visit a hospital, simply show your I.D. card. If the hospital does not participate with your POS, you will need to file a claim. Your complete benefit program is available when you or your Dependents are traveling. You receive the same benefits as described in this Plan Document. Remember that Medicare does not pay for hospital or other medical expenses outside the U.S. If you plan to travel abroad, consider obtaining additional insurance.
Yes-A listing of the Plan’s Summary of Benefits can be found in the SPD and SMM’s.
A listing of the Plan’s Service providers contact information can be found under Welfare Fund Contacts.
Yes- The following Life Insurance is provided for Employees only under the Plan:
Active Eligible Employees: $50,000.00
Retired Employees: $10,000.00
Local 1 Represented Employees: $3,000.00
(Employees represented by Local Union No. 1 who are employed under the terms of an agreement between Local Union No.1 and an Employer, who are not currently eligible as an Active Employee or a Retired Employee but who previously contributed to the Plan.)
You should have a beneficiary designation form on file with the Fund. This form is available under the “Forms” tab or you can logon the the MyBenefits portal and manage Beneficiary designations and updates there.
You may designate one or more beneficiaries on the “Beneficiary Form” provided by the Fund. You may change your beneficiary at any time by updating your beneficiary information on file via an updated form or a MyBenefits update. A designation of beneficiary will become effective only upon its receipt by the Fund. The last effective designation received by the Fund prior to your death will supersede all prior designations. A designation of beneficiary will not be effective if the designated beneficiary dies before you.
You must complete the actual form provided by the Plumbers Local Union Trust Funds. No other form of designation may be used. Completion of forms for the 401(k) Savings Plan, United Association National Pension Fund, or the United Association Burial Expense Benefit does not meet this requirement.
If you have not provided a designation of beneficiary form to the Plumbers Local Union No. 1 Trust Funds, you should do so without delay.
If there is no beneficiary - If you have not designated a beneficiary, or if your beneficiary is not living at the time of your death, your account will be paid as outlined within the Summary Plan Description.
Due to the many important documents that could be mailed to this new address, the Plumbers Local Union No.1 Trust Funds requires that the member in writing must confirm a request for change of address.
Do I need to inform Local 1, the United Association, and United Association National Pension Fund of my new address? Yes, below find the related contact information.
Plumbers Local Union No.1
› Address
50-02 Fifth Street, 2nd Floor
Long Island City, New York 11101
› Phone
1 - 718 – 738 - 7500
United Association
› Address
901 Massachusetts Avenue N.W.
Washington, D.C. 20001
› Phone
1 - 202 – 628 - 5823
United Association National Pension Fund
› Address
103 Oronoco Street
Alexandria, Virginia 22314
› Phone
1 - 800 – 638 - 7442
The HRA will reimburse Eligible Health Care Expenses incurred by you and your Qualified Relatives during your period of coverage. “Eligible Health Care Expenses” are generally those expenses that would be an eligible deduction on your tax return (but without regard to the requirement that such expenses exceed a specified amount of your income) in accordance with IRS rules. These expenses cannot be covered by any other benefit plan. Following is a list of some examples of expenses which are reimbursable if they are not covered by a health care plan:
- Prescription Drug co-payments;
- Medical co-payments and annual deductibles;
- Medicare Part “B” monthly premiums;
- COBRA monthly premiums;
- Unemployment Continuation of Coverage premiums;
- Long-term care insurance premiums (For taxable years beginning in 2024,limits specified under Section 213(d) and 7702B(b) of the Internal Revenue Code.
WILL ALL PHARMACIES AND MERCHANTS ACCEPT MY HRA DEBIT CARD?
Most in person and online pharmacies accept the Debit Card. Please ensure you have enough money in your HRA account for the full transaction amount. If you try and run your card for any amount over your available balance, the card will decline. Please check the Mobile App for your most up to date account balance information.
If your pharmacy does not accept the Debit Card, effective January 1, 2024 you can file a claim for reimbursement via the WEX portal, Mobile App or paper claim process. You will need to provide a copy of your receipt or Rx bag tag for manual claims submissions.
Click Here, for information on how to find a pharmacy or store. You can also go to
https://sig-is.org/storelocator.
An HRA claim can be filed up to 36 months from the date the reimbursable expense was incurred. (12 months effective 1/1/2025).
You will have the option to use the WEX Portal or Mobile App to file a claim and upload your receipts. You can also continue to file paper claims. You or your provider must first submit a claim for the expense to any benefit plan in which you are covered for the same services. For a list of HRA expenses which may be submitted, see the Eligible Expenses section in the SPD. You must have itemized bills with the name of the patient and provider or the date(s) of service or supply and the type of service or supply for each expense. Canceled checks and balance forward statements cannot be used for claim purposes. For claim expenses greater than $500, you can submit a balance forward statement and designate the HRA claim as "pay to Provider." You can submit a claim as often as necessary.
The minimum claim payment is $25 which means that the Fund does not reimburse Eligible Expenses until you have submitted at least $25 in reimbursable expenses and at least $25 is available in your HRA account. Claims submitted or awaiting payment that are less than $25 will be reimbursed quarterly. All reimbursements will be made payable to the Employee.
HRA claims are processed no later than 30-days from date received by the Fund. You will receive an Explanation of Benefits for each denied claim. HRA statements showing your balance will be mailed to you at the end of each Plan Year.
Click Here to view reimbursable expenses.
FEDERAL LAW RESTRICTS THE TYPES OF EXPENSES THAT MAY BE PAID FROM YOUR HRA. THE TRUSTEES CANNOT CHANGE THESE RULES.
Click Here for terms and conditions