UAW Local 1268

Local 1268 Unit 1

Steps to follow for filing a SICKNESS and ACCIDENT (S&A) Claim

Employees that go on sick leave must call 1-800-810-2271 to report your absence 30 minutes prior to the start of the shift and get a call in number for the first day of absence. Employees should also call Sedgwick at 1-888-322-4462 to get your Sickness and Accident (S&A) claim started. Your S&A claim must be called in within 20 calendar days of the date your disability commenced. Your doctor must also call Sedgwick at 1-888-322-4462 to report your medical information within 90 days of your release date. Claims will not be paid unless you name your doctor both call Sedgwick within the above time limits and meet eligibility requirements. An S&A claim will start with the first day you were physically treated by your doctor. When an injury occurs, your S&A pay will begin from day one as long as you are TREATED WITHIN 24 HOURS BY A DOCTOR OR HOSPITAL; all others will be required to serve a 3 day waiting period. For example:

S&A Claims with a 3-day waiting period

• Inpatient hospitalization
• Outpatient
• Inpatient observation
• Illness
• Injuries or accidents NOT treated within 24 hours

S&A Claims that pay from day-1

• Injury or Accident treated within 24 hours by a doctor or hospital

Sick leave is payable Monday through Friday only and does not include Sat. or Sun. even if you are scheduled to work. Sedgwick may send you for a second opinion to a doctor of their choice. They will notify you by a letter from UPS or a phone call. Make sure that your correct mailing address and phone number is listed with the Plant Employment office. Failure to show up or to be late for the second opinion exam, will cause Sedgwick to stop your S&A pay.

If the second opinion doctor says you are able to work, you must report to the plant doctor for a third opinion. Failure to follow any of these steps will result in termination of your S&A benefits.

In order for you to receive S&A pay, you and your doctor must call Sedgwick and meet the eligibility requirements. If you or your doctor misses the Wednesday deadline, your claim will be processed the following week. Checks are processed on Thursday and mailed or EFT on Friday. S&A pay is based on your rate pay.

If your sick leave needs to be extended, you must be physically treated by your doctor prior to your original sick leave end date and have your doctor call Sedgwick and you must call the Absentee call-in number: 1-800-810-2271 to extend your return to work date.

In order to continue your Optional Life Insurance while on sick leave, you must call Benefit Express at 1-888-456-7800 within 30 days to request payment coupons. Your monthly deductions are taken ONLY from your payroll checks not from your S&A checks. You may also ask Benefit Express how long your Medical/Dental coverage will stay active based on your seniority.

You are required to reinstate through personnel the day before your return to work date. You can pick up the reinstatement form from personnel.

REPORTING YOUR ABSENCE

1. Get a Call in Number call 1-800-810-2271

2. Record your call in number

3. Call in 30 minutes prior to start of shift

APPLYING FOR SICKNESS & ACCIDENT BENEFITS (S&A)

1. Call Sedgwick 1-888-322-4462

2. Record your call in number

3. Have your Doctor call Sedgwick 1-888-322-4462

ELIGIBILITY

To be eligible for S&A Benefits you must:

• Be totally disabled and unable to work with restrictions
• Be unable to perform all duties of your occupation
• Be under the continuous care of a legally licensed physician who certifies your total disability
• Furnish written notice of claim and satisfactory proof of disability on a timely basis
• Reinstatement Form Unit 1

Appealing Denied Sickness and Accident (S&A)Claims Procedure

For Sickness and Accident Claims that are denied, we will need the following information within (45) days to file and appeal on your behalf to the International Union.

• A letter from your Doctor stating that your are/were totally unable to work
• All Doctor notes pertaining to your Sickness and Accident claim
• If you were injured, have your Doctor give the date of injury and how it occurred
• A list of all medications and the directions on how you take the medication
• All treatment dates
• An estimated return to work date from your Doctor
• Have the Doctor list his treatment plan and any procedures you had (MRI, X-rays, physical therapy etc.) You must submit the results of the procedure or if you had physical therapy you will need a letter describing your progress or a copy of the medical notes describing the therapy.
• If you were treated or admitted to the hospital, you must provide a copy of your E.R. report indicating the duration and reason for the hospitalization
• If more than one Doctor treated you, please have all the Doctors call Sedgwick and provide all of the information that is listed above
• A written statement from you asking to Appeal the Decision of Denial for your S&A. In your own words explain why you were off work and applying for S&A.

Appeals may take 2 to 3 months for reconsideration. You will receive notice by mail as soon as the appeal has been met on by the Company and the International Union and a decision has been reached.

UAW LOCAL 1268 Benefit Representatives

Charrise Herron-Staten- (815) 547-2468

David Ingram- (815) 547-2118

Valerie Hanserd- (815) 547-2460  

What happens to my Health Care benefits if I am laid off?

GENERAL SUB INFORMATION

When Coverage Stops

Hospital, Surgical, Medical, Dental, Vision and Hearing (HSMDVH) coverage remanins in effect until the end of the month following the month in which your layoff begins. HSMDVH coverage continues on the basis of your years of seniority as of the date your layoff begins in accordance with the following table:

Years of Seniority on Date Layoff Begins Maximum Number of Months for Which Corporation Provided Coverage is Continued

After the last month for which the company provides coverage, you may continue HSMDVH coverage for a period of 12 additional months by paying the required monthly premium amount for such coverage.

Cash-Pay Administrator

The cash-pay administator is Benefit Express regardless of the health care plan in which you are enrolled. You must contact Benefit Express at 888-456-7800 within thirty (30) days prior to your coverage termination if you wish to continue coverage.

Dental Coverage

Dental coverage remains  in effect until the end of the following the calendar month following the month in which your layoff begins. Thereafter, dental coverage may not be continued.

Optional  Dependant Group Life (OGL & DGL) Insurance

When Coverage Stops

If you are laid off, your insurance coverage will continue through the end of the month covered by your payroll deduction. Thereafter, you may continue your optional group life insurance by paying the required premiums to Benefit Express. The insurance may be continued for a period (not to exceed 24 months) equal to that for which you may be covered for company-provided coverage under the Life and Disability Program, and thereafter for an additional 12 months.

Continuation of Coverage

You will receive notification from Benefit Express instructing you  to contact them if you wish to continue coverage through monthly direct billing. Contact Benefit Express at 1-888-456-7800 for additional information.

OGL/DGL Conversion to an Individual Policy

Within thirty-one (31) days after group coverage terminates, you may convert such coverage, without medical examination, to an individual policy by contacting MetLife at 1-888-892-5472.

If you have any further questions feel free to call your UAW Benefits Representatives.

Charrise Herron-Staten- (815) 547-2468

David Ingram- (815) 547-2118

Valerie Hanserd- (815) 547-2460

DELTA DENTAL BENEFITS OVERVIEW

Maximum- Actives ($1,850.00) per year (Jan. thru Dec.) for each person on your Dental plan.

Cleanings- 2 per year

If there is documented history of periodontal disease 3 cleanings will be allowed.

Dental X-Rays- Full mouth x-rays, once every 5 years.

Bitewing x-rays- Age 15 and older every 2 years (changed from once a year).

Age 14 and younger once a year.

Orthodontics- (Up to age 19) Covered at 50% up to lifetime maximum.

Active- Lifetime maximum of $2,200.00

Providers- Always make sure the dentist is participating with Delta.  Even if you are referred to another dentist it is your responsibility to make sure the dentist is participating (they have a contract with Delta Dental).  Directories are  available in the UAW Benefits Office or you can call:

Delta: 1-888-293-8271.

Delta Dental ID Number- Is your social security number

Group Number- 8220

NOTE:  JULY 1, 2009 RETIREES NO LONGER HAVE DENTAL OR VISION BENEFITS.

IMPORTANT INSURANCE CHANGES FOR DEPENDENTS AGES 19 – 26

The UAW Benefits Office has just been informed that if a member has a biological or stepchild dependent (age19-26) they can be covered on your medical insurance REGARDLESS if they are offered or enrolled in medical insurance through their place of employment.  Previously, if your dependent was offered or enrolled in medical insurance through their place of employment you were not able to cover this dependent on your medical coverage only on the dental and the vision coverage. 

If you have dropped a dependent because they were offered or enrolled in medical through their place of employment you can call Benefit Express (1-888-456-7800) to add this dependent back on to your medical coverage retroactive to January 1, 2012.  If you have any problems when you make this call, contact us immediately.

Please be mindful that if your dependent has dual coverage (coverage through Chrysler and another healthcare provider) it is their responsibility to check with the other healthcare provider to see what their rules are regarding dual coverage. If a dependent’s parents both work at Chrysler then that dependent can only be covered by one parent (they cannot have dual Chrysler coverage).  Also, if a dependent works at Chrysler and is also covered by a parent who works at Chrysler they will have to choose whether they want to be covered under their own healthcare coverage or their parent’s healthcare coverage (they cannot have dual Chrysler coverage).  

QUESTIONS ETC.- If you have a question regarding your benefits please do not hesitate to stop by or call us.

Charrise- (815) 547-2468

Dave- (815) 547-2118

Valerie- (815) 547-2460

Due to the Post Office cutting cost, mail will no longer be sorted on Saturdays.

Retirees who are receiving paper checks will experience longer delays in receiving their pension checks. We encourage you to sign up for Direct Deposit of your pension check. Your UAW Benefit Representatives can assist you. We will need your bank’s name, routing number and checking or savings account number.

Charrise Herron-Staten- (815) 547-2468

David Ingram- (815) 547-2118

Valerie Hanserd- (815) 547-2460

Effective January 1, 2011 hourly bargaining unit employees will be able to cover dependents until the end of the month they turn 26 years old.  NOTE: THIS ONLY APPLIES TO MEDICAL COVERAGE NOT DENTAL AND VISION.  DEPENDENT CHILDREN CAN ONLY RECEIVE DENTAL AND VISION BENEFITS UNTIL AGE 24 (must be a full-time student, proof of  residency and claimed as a dependent on your federal taxes).

The Special Enrollment period will be November 1-30, 2010.

To add dependents for an effective date of January 1, 2011.  If you add a dependent in December then the effective date will be February 1, 2011.  Letters will be mailed to all employees explaining the guidelines.

EMERGENCY ROOM VISITS- ER Claims are being heavily scrutinized by providers.  If you are able to go to a clinic or urgent care facilities please do so.  Physicians Immediate Care has several locations operating at different hours and they participate with Blue Cross Blue Shield and Humana.  You can stop by the Benefits Office to get a list of participating facilities.

QUESTIONS ETC.- If you have a question regarding your benefits please do not hesitate to stop by or call us.

Charrise- (815) 547-2468

Dave- (815) 547-2118

Valerie- (815) 547-2460