ON-LINE ENROLLMENT FORM
(Click Link Below for Annual Enrollment Form)

ANNUAL ENROLLMENT FORM (AEF)

 


 RECIPROCAL POLICY effective July 1, 2014

Pension Reciprocal Listing by Local Union Number (click here)
B = Defined Benefit
C = Defined Contribution


NEW PRE-CERTIFICATION AND UTILIZATION MANAGEMENT PROVIDER EFFECTIVE SEPTEMBER 1, 2013 IS ANTHEM BLUE CROSS AND BLUE SHIELD. 1-866-643-7087. www.anthem.com (click here for informational flyer)            


 IBEW #481 Defined Contribution Plan & Trust
Terminated Vested Participant Application
 Click Here

You will need to provide the following documents:

A copy of your Birth Certificate
A copy of your Marriage Certificate (if applicable)
A copy of your Divorce Decree (if applicable)
A copy of your Employment Termination Slip

Revised Termianted Participant Rules Effective August 1, 2014
Click Here


Participant Distributions are paid in 2 separate payments.  The first payment will be approximately 90% of your last know account balance and will be paid within 10 business day following receipt of your approved application.  The second payment (the remaining balance) will arrive approximately 60 days from the end of the quarter in which your first payment was issued.  The quarters end March 31st, June 30th, September 30th, and December 31st.


Effective January 1, 2008 the Trustees established a Health Reimbursement Account (HRA). To view the HRA policy, please visit the "Summary Plan Description - Benefit Fund Summary of Material Modifications" below.  The current employer contribution rate to your individual HRA account is $0.50 per hour.  These monies can be used for certain expenses, as allowed by law.  Click here to view IRS Publication 502 for a list of  includible and not includible expenses.  Claims on the HRA account must be filed within 6 months of the date the expense was incurred. Eligible claims must total a minimum of $25.00 per person.

H.R.A. Forfeiture Rules (click here)
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ALL ELIGIBLE RETIREMENTS REQUIRE THE FOLLOWING ITEMS:
1.  Your birth certificate
2.  Your spouse's birth certificate (if applicable)
3.  Your marriage certificate (if applicable)
4.  Your divorce decree (if applicable)
5.  Your employment termination slip
 
6.  A severance of employment for a minimum of 30 days

Please contact Bob Cadwell at (317) 923-4577, ext. 200 for an individual retirement planning appointment.
_______________________________________________________________________________
Benefits Online Links:
Benefits Login
For your first time login, you will be required to have your Social Security number for the ID (do not use the dashes. ie: 123456789) and use GEN4681 as the password. Follow the on-screen instructions to complete your sign in process.


IBEW #481 Defined Contriubiton Plan Earning Rates
 
Summary Plan Descriptions(SPD):

Benefit Fund  (revised 1/1/2012)
Benefit Fund Amendments

Construction Electricians (CE) Benefit Fund

Pension Fund  (revised 7/1/2012)
Pension Fund Amendments

Money Purchase Plan  (revised 7/1/2012)
MPPP Amendments

 


Forms and Information: 

Designation of Beneficiary Form HIPAA Privacy Notice
 
Participant Data Card Claim Form
 
Claim Appeal Procedure Loss of Time Statement
 
Annual Enrollment Form (PDF Version) Subrogation Agreement Form
 
Change of Address Form HIPAA Authorization Form
 
Loss-of-Time Tax Form Eligibility Requirements Chart
 
Dental Preferred Providers Suspension of Pension Benefit Application
 
Anthem Claim Form Direct Deposit Form
   
Health Reimbursement Account (HRA) Claim Form Summary of Death Benefits
 

H.R.A. Claim Form (PDF version) 

Retiree Return to Employment Form

C.H.I.P. Notice 


Tax Withholding Form - Pension 

MPPP Retirement Application

 Affidavit

New Healthcare Marketplaces (Exchanges)

 2014 SBC Mailing - includes AEF

Reciprocal Forms Vision Fee Schedule

 Additional Links:

Anthem

Prescription Benefit Manager: SAV-RX Site

United Health Care

ProCare Network

E.R.T.S. (Electronic Reciprocity Transfer System)

Health Reimbursement Account (HRA) Publication 502 Regulations

YMCA OF GREATER INDIANAPOLIS http://www.indymca.org/
 

  

ELECTRICAL WORKERS FRINGE BENEFIT
ADMINISTRATIVE OFFICE

Robert G. Cadwell, Administrative Manager
1828 N. Meridian Street, Suite 103
Indianapolis, IN  46202

(317) 923-4577
Fax: (317) 923-7633

email: info@ewbtf.org

Office Hours:
M,T,TH, F = 8:00 A.M. to 4:30 P.M.
W = 8:00 A.M. to 6:00 P.M.

 

 

 

© Copyright 2003,2004, International Brotherhood of Electrical Workers Local Union #481, All Rights Reserved.