Your Rights Under ERISA
As a participant in the MILA National Health Plan, you
are entitled to certain rights and protections under the
Employee Retirement Income Security Act of 1974
(ERISA). ERISA provides that all Plan participants shall
be entitled to:
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Examine, without charge, at the MILA Managed
Health Care Trust Fund office (55 Broadway, 27th
Floor, New York, NY 10006) and at other specified
locations, such as worksites and union halls,
all documents governing the Plan, including the
Plan, insurance contracts (if any), vendor contracts,
collective bargaining agreements, and a copy of the
latest annual report (Form 5500 series) filed by the
Plan administrator with the U.S. Department of
Labor and available at the Public Disclosure Room of
the Employee Benefits Security Administration;
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Obtain, upon written request to the Plan administrator,
copies of documents governing the operation of
the Plan, including the Plan, insurance contracts (if
any), vendor contracts, collective bargaining agreements,
and copies of the latest annual report (Form
5500 series) and updated Summary Plan Description.
The administrator may make a reasonable charge for
the copies; and
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Receive a summary of the Plan’s annual financial
report. The Fund is required by law to furnish
each participant with a copy of this summary
annual report.
You are entitled to continue health care coverage for
yourself, your spouse or your dependents if there is a loss
of coverage under the Plan as a result of a qualifying event.
You or your dependents may have to pay for such coverage.
You should review this website and the documents governing
the Plan for the rules governing your COBRA continuation
coverage rights.
In addition to creating rights for Plan participants, ERISA
imposes duties upon the people who are responsible for
the operation of the Plan. The people who operate the
Plan, called “fiduciaries” of the Plan, have a duty to do
so prudently and in the interest of you and other Plan
participants and beneficiaries. No one, including your
employer or any other person, may fire you or otherwise
discriminate against you in any way to prevent you from
obtaining a welfare benefit or exercising your rights
under ERISA.
Note
If your claim for a welfare benefit is denied
or ignored, in whole or in part, you have a
right to know why this was done, to obtain
copies of documents relating to the decision
without charge, and to appeal any denial, all
within certain time limits.
Under ERISA, there are steps you can take to enforce your
rights. For instance, if:
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You request materials from the Fund and do not
receive them within 30 days, you may file suit in a
federal court. In such a case, the court may require
the Fund to provide the materials and pay you up to
$110 a day until you receive the materials, unless the
materials were not sent because of reasons beyond the
control of the Plan administrator.
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You have a claim for benefits which is denied or
ignored, in whole or in part, you may file suit in a state
or federal court. In addition, if you disagree with the
Plan’s decision or lack thereof concerning the qualified
status of a medical child support order, you may file
suit in federal court.
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If it should happen that Plan fiduciaries misuse the
Plan’s money, or if you are discriminated against for
asserting your rights, you may seek assistance from the
U.S. Department of Labor, or you may file suit in a
federal court. The court will decide who should pay
court costs and legal fees. If you are successful the
court may order the entity you have sued to pay these
costs and fees. If you lose, the court may order you to
pay these costs and fees, for example, if it finds your
claim is frivolous.
If you have any questions about your Plan, you should
contact the Plan administrator. If you have any questions
about this statement or about your rights under ERISA,
or if you need assistance in obtaining documents from
the Fund, you should contact the nearest office of
the Employee Benefits Security Administration,
U.S. Department of Labor, listed in your telephone
directory, or:
The Division of Technical Assistance and Inquiries
Employee Benefits Security Administration
U.S. Department of Labor
200 Constitution Avenue N.W.
Washington, DC 20210
You may also obtain certain publications about your
rights and responsibilities under ERISA by calling
the publications hotline of the Employee Benefits
Security Administration.