Policy Terms & Conditions

Effective Date: August 3, 2023

I hereby elect to participate in the IUPAT VIP Voluntary Group Insurance Plan by enrolling in the group benefit(s) that I have selected.

I certify that I am an active, U.S.-based, full dues-paying member of IUPAT, currently working for an employer under a collectively bargained agreement.  I have read the completed enrollment documents and understand that any false statements or misrepresentations during this enrollment may result in the loss of coverage or denial of benefits under this group policy.  I understand that submission of this form does not guarantee coverage.  Coverage will not become effective until the insurance company or its designated underwriter approves.

I attest that the information provided above is true and correct to the best of my knowledge. I understand that knowingly defrauding an insurer, including but not limited to submitting a fraudulent application, intentionally enrolling in benefits I know I am ineligible for, or filing a claim containing false or deceptive statement(s), may violate state or federal law(s).

If I waive any line of coverage and later decide to enroll or if I later decide to increase any elected benefit, I understand that late entrant consequences may apply. These include, but are not limited to, that I may be restricted to when I can enroll or increase coverage, the amounts in which I can elect, and I may have to provide proof of insurability at my own expense. I acknowledge that the insurance carrier has the right to reject my request.

I understand that nothing stated in these Terms and Conditions supersedes the policy booklet and that for exact language and full details, I should refer to the policy booklet, which can be requested by emailing info@unionone.com.

A. Eligibility

Enrollment Eligibility Rules: These rules outline the requirements for being initially eligible for coverage on the effective date for which you enroll.

1. Membership Requirement:

• You must be an actively working, full dues-paying Member of the IUPAT, living in the U.S.

2. Employment and Actively Working Requirement:

• You must be employed under a U.S.-based collectively bargained contract on the effective date of coverage.
• You must be actively working on or immediately before your effective date of coverage (based on when you enroll) to be eligible. This means performing your job duties for your employer on that specific date. If you are not actively working, your coverage will only start once you return to actively working status. “Actively working” is defined as working a full day as scheduled by your employer, performing the duties of your regular occupation.
• If you are not currently employed, meaning you do not have an employer, you are not eligible to enroll.

3. Disability Prior to Coverage: If your date of disability is prior to the coverage effective date, it will not be eligible for benefits, and you will not be covered under the policy until you return to actively working status.

Post Enrollment Eligibility Rules: These outline the requirements to maintain eligibility once you are initially covered on the plan (as determined above).

1. Membership Requirement: You must remain an actively working, full dues-paying Member of the IUPAT living in the U.S.
2. Maintaining Employment and Working Status Requirement: You must remain employed under a U.S.-based collectively bargained contract and meet the requirements below.
   • Work Hours Requirement: You must work at least 750 hours per year.
   • Continuity Requirement: You must not have a break in active work longer than 6 consecutive months.

If you have a question about eligibility or if your eligibility changes, please call Union One at (224) 357-7880.

B. Enrollment Adjustments, Additions and Re-Enrollments

1. Waiting Period for Coverage Adjustments

• Once a member elects coverage, they must wait one full year from their original effective date before making changes. This includes:
  • Salary changes
  • Premium increases due to moving into a new age bracket
  • Disability (STD and LTD) coverage increases.
    • This increase must be done during an approved enrollment period occurring after the one year waiting period is satisfied.
  • Life insurance increases – a Member may only increase coverage by a maximum of two increments at any one time.
    • This increase must be done during an approved enrollment period occurring after the one year waiting period is satisfied.
  • After any coverage increase is made, the Member must wait another full year before making any subsequent increases.

2. Adding Lines of Coverage at Future Enrollment Dates

• Members who enroll, but choose to opt out of enrolling in Life or Disability coverage may add that coverage during future enrollment periods, with the following conditions:
  • Disability Insurance: Pre-existing condition exclusions apply to any additions if the member previously opted out.
  • Life Insurance: Members may elect coverage by up to two increments.

3. Re-Enrolling in Coverage after a Cancellation

• If a Member voluntarily cancels coverage or is cancelled due to non-payment, that Member must wait one full year from the date of cancellation before re-enrolling in coverage, and then can only re-enroll during an approved enrollment period.

C. Policy Review and Acknowledgement

I understand it is my responsibility to understand the group policy and its provisions. I am responsible for obtaining a copy and reading the entire group policy booklet.  A copy of the group policy booklet will be available by contacting Union One Benefits Administration (“Union One”) at info@unionone.com. I acknowledge and consent to receiving electronic copies of group plan documents in lieu of paper copies to the extent permitted by applicable law. I may change this election only by providing thirty (30) days prior written notice to Union One.

I understand that this group plan may have limitations and exclusions. These limitations and exclusions include, but are not limited to, pre-existing condition limitations and limitations on specific disabling conditions such as mental health, substance abuse, and musculoskeletal conditions. Limitations may vary based on the state in which I reside.  Additional information regarding limitations and exclusions can be found in the group policy booklet.

D. Disability Insurance Notice

Your Union Long-Term Disability Policy (5-year Duration Option Only) through Sun Life contains a two year “own-occupation” period within the definition of disability. During the first 2 years of a Long-Term Disability claim, your disabling condition must prevent you from performing the “essential duties” of YOUR specific occupation (as defined by the Department of Labor). After 2 years of receiving Long-Term Disability benefits, you would transition from “own-occupation” to “any-occupation”.

Generally, the following criteria is used when determining whether you can work in another (“any”) occupation:

• Occupations exist within your job market (approximately 60 miles commute or less, considering your length of travel to work prior to disability) that you could perform with your disability/functionality restrictions.
• Occupations exist that you can perform the majority of the substantial and material duties for and have the education, training, or experience to perform.
• Occupations exist that pay a reasonable amount as defined in the policy booklet.
• The transition from the own-occupation definition of disability to the any-occupation definition does not in itself eliminate your ability to receive benefits. This transition is a change in the criteria used to adjudicate your disability and may or may not cause benefits to terminate (depending on each unique situation and the criteria above). Job openings/availability are not guaranteed nor does the policy protect against whether you successfully secure employment.

For STD & LTD: THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.  These policies provide disability income insurance only. They do NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.

E. Pre-Existing Condition Limitations

Disability Pre-Existing Conditions Limitations: For the first 12 months of your coverage or for any increases/enhancements to your coverage, no Short-Term Disability (STD) or Long-Term Disability (LTD) benefits will be paid if your disability results from a pre-existing condition. A pre-existing condition is defined as any illness or injury for which you:

• Received medical treatment, consultation, or diagnostic testing
• Were prescribed medications or followed any treatment recommendations

This also includes conditions for which you did not see a doctor, but a reasonable person would have sought medical care. Please note that exclusions may vary by state.

To qualify for benefits related to a pre-existing condition:

• You must be an eligible Member of the group and have paid premiums for a minimum of 12 consecutive months following your effective date of coverage (or the effective date of any increases/enhancements to your coverage) and prior to your disability, or
• You must be treatment-free for the 3 months prior to your coverage effective date (Look Back Period) for the disabling condition. The Look Back Period is the timeframe during which your medical history is reviewed to determine if a disabling condition existed prior to your coverage effective date (or the effective date of any increases/enhancements to your coverage). To meet the criteria for being “treatment-free” during the Look Back Period, the following must apply:
  • Resolution of the Condition: The pre-existing condition must be resolved, meaning it no longer requires ongoing medical treatment, prescription medications, consultations, or diagnostic testing during the Look Back Period.
  • No Ongoing Management or Treatment: Simply discontinuing or avoiding treatment does not qualify as “treatment-free.” The condition must not require further management or intervention by a healthcare provider during this period.

Additional Information About Pre-Existing Conditions Limitations

• These limitations apply to any increase in your disability benefits.
• The insurance carrier will review pre-existing conditions at the time of claim. This review requires disclosure of all relevant medical records, doctors’ notes, and prescription drug history.
• Failing to receive treatment does not exempt you from the Look Back Period for pre-existing conditions.

F. Life Insurance Notice

This is a Voluntary Group Term Life Insurance plan offered through your union. As such, this plan should not serve as your primary source of Life Insurance as the union or insurance company may terminate, cancel or change this policy at renewal. This Life Insurance Plan is designed to give you and your family a guaranteed approved option for additional Supplemental Life Insurance while working and an active Member of your union. Please review all the provisions of this Life Insurance Policy and it is highly recommended that this policy not be used to replace any existing Life Insurance coverage you may have.

When Life Insurance Coverage Ends

• If disabled, you may keep your Life Insurance coverage for up to 12 months provided premiums continue to be paid during that period. Beyond 12 months, your coverage will terminate unless you convert or port your Life Insurance coverage.
• If you leave the union or retire, you may convert your Group Term Life Insurance to a Permanent Individual Life Insurance Policy or you may port your coverage. I understand that, should I choose to, I must convert my life insurance within 31 days of my coverage terminating. Please contact the IUPAT VIP administrative office at (224) 357-7880 for questions about rates associated with converting or porting your Life Insurance coverage.
• Children must be under the age of 26 years old to be eligible for Child Life coverage. If you enroll in Child Life coverage and your child is disabled, you can retain your child’s coverage beyond age 26 by contacting the IUPAT VIP Plan’s customer service center at (224) 357-7880 or by email at info@unionone.com.
• Note: Typically converting your Group Term Life Insurance into an Individual Permanent Life Insurance Policy is very expensive and only recommended for people who cannot qualify for Life Insurance elsewhere.

Dependent Life Insurance: I understand that my Spouse and Dependent(s) cannot be enrolled in Spouse and or Dependent life insurance if I am not also enrolled in that same benefit of an equal or greater amount. I understand that neither my Spouse nor I can be covered as both a Member and a Spouse on this plan at the same time.  Furthermore, I understand that a Dependent cannot be covered by more than one Member under this plan at the same time.  Life insurance coverage for a dependent other than a newborn child will not take effect if that dependent is confined to a hospital or other health care facility, is home-confined, or is unable to perform the normal activities of someone of like age and sex.  I acknowledge that any spouse or dependent for whom I elect coverage must meet the eligibility requirements described in the plan documents, which are available upon request by emailing info@unionone.com or calling (224) 357-7880. I understand that these requirements may change at renewal or as directed by the union or any applicable state regulations. I accept full responsibility for promptly notifying Union One if my spouse or dependent no longer meets these requirements. I also understand that failing to do so may result in the loss of continuation of coverage rights under the plan. I further acknowledge that premiums paid for an ineligible spouse or dependent will not be refunded, and any claims submitted for an ineligible spouse or dependent will be denied.

G. Participant and Claimant Responsibilities

I understand that if my date of disability or date of death (Member, Spouse, or Dependent) occurs prior to the coverage effective date it will not be covered. Further, I understand that to be approved for a disability claim, I must meet the definition of disability and be under the care of a physician. I am aware that Short-Term Disability and Long-Term Disability each have unique definitions of disability, and Long-Term Disability may include both own occupation and any occupation language (as described above).

I am aware that if I have provided an income during the enrollment process that is greater than what I make, I will not receive benefits on the overstated income amount. I further understand that the disability benefit I elect cannot exceed 60% of the applicable income that I can prove at time of claim based on the policy’s income definition.  If I file a claim, I will be required to provide documentation of my income, and my benefit may be adjusted if I cannot verify the income I provided.  I am also aware that I have confirmed that I meet the minimum hours worked requirements of the group policy as stated above.  Verification of my hours worked will be required if I file a claim, and not meeting the minimum hours worked requirement will make me ineligible to receive benefits.  I am responsible for informing Union One immediately by calling (224) 357-7880 if my earnings change or if I no longer meet the minimum number of hours worked. Failure to do so could result in a loss of premium.

I understand that if I file a disability claim, my benefit could be subject to offsets from other applicable benefits I may be entitled to (e.g., Social Security Disability, Worker’s Compensation, Health and Welfare Disability Benefits, State PFML or Disability Benefits, etc.), which could decrease the amount of benefit I receive. I also understand that I will be required to pay back any overpayments in benefits I receive under this plan, even if the overpayment is of no fault of my own.

I understand that both Short-Term Disability and Long-Term Disability have unpaid waiting periods, called Elimination Periods, that I must satisfy before being eligible for benefits, and that one approved, benefits do not retroactively begin from the start of my disability.  I also understand that completion of the Elimination Period does not directly correlate to when I will receive benefit payments, but rather is the time disabled I must satisfy to be eligible for my claim to be eligible and evaluated benefit payment.

H. Communication Acknowledgement

I understand that by providing my cell phone number and email, I am opting in to receive periodic text messages and emails from Union One regarding the plan’s benefits, renewals, open enrollments, claim information, and periodic union updates. Data obtained from me in connection with text message notifications may include my cell phone number, cell phone carrier, the date, time, and content of my messages, as well as other information I provide.

I can cancel text and email notifications anytime by contacting Union One. As always, message and data rates may apply to any messages I send or receive.  Union One will not be liable for delays in receiving text or email messages as delivery is subject to effective transmission from your mobile and email service provider. By subscribing or otherwise using the service, I acknowledge and agree that Union One will have the right to change and/or terminate the service at any time, with or without cause and/or advance notice.

I. ACH Authorization

I authorize Union One Benefits Administration, Inc (“Union One”) to electronically debit and credit my designated deposit account at my designated depository financial institution (my “Bank Account”) via ACH and, if ever applicable, to correct debits and credits via ACH as follows:

• Frequency of Debits: On the closest Business Day to the date of my selected draft (however, debits and credits may not necessarily occur every Business Day). For purposes of these Terms, “Business Day” means Monday through Friday, excluding federal banking holidays.
• I authorize Union One to process debit entries to my account. I understand that this authorization will remain in full force and effect until I notify in writing that I wish to revoke this authorization by emailing info@unionone.com, or mailing notice to 28160 W. Northwest Hwy., Suite 203 Lake Barrington, IL 60010. I understand it requires at least 30 days’ notice prior to my next payment date to cancel this authorization. If I cancel this authorization, I understand that I will no longer have access to my Union One Account or the Services providing by this plan, except as expressly provided in these Terms.
• I understand that premium rates and benefits may change at or before renewal as agreed upon by the union group policyholder and the insurance carrier.
• I acknowledge and understand that the premium rates for the coverage(s) I have elected are age-banded and will increase automatically as I move into a new age bracket. These rate changes will take effect on the anniversary of the group policy following my birthday, in accordance with the carrier’s rate schedule. I understand that Union One is not contractually or legally obligated to notify me in advance of these increases. However, Union One will make a good faith effort to provide notice when feasible. By signing this application and enrolling in coverage, I expressly consent to the continuation of my coverage at the adjusted premium rate when age-band increases occur. I authorize Union One to update my account accordingly, including modifying any recurring ACH or other payment methods to reflect the new premium amount. I also acknowledge that it is my responsibility to review my coverage and billing details on an ongoing basis and to contact Union One with any questions or concerns related to rate changes or payment adjustments. This acknowledgment remains in effect for the duration of my participation in the group policy, including any future age-based premium changes.
• I agree not to dispute this recurring transaction with my bank provided the transaction corresponds to the terms indicated in this authorization form. Please note, “UNIONHUB PYMT” will appear on your bank statements and your monthly costs for the benefits you elected will be deducted on the day(s) you selected when enrolling.

In addition to any of your other representations and warranties in these Terms, I represent that: (a) my browser is equipped with at least 128-bit security encryption; (b) I am capable of printing, storing, or otherwise saving a copy of this electronic authorization for my records; and (c) the ACH transactions I hereby authorize are for benefits for which I am eligible.

J. Premium Payments, Calculations, and Adjustments

Renewal Notice: This is a Group Insurance Plan offered through your union. As such, at renewal your rates and benefits may change or non-renew based on the overall claims experience of the group and/or participation requirements not being met. Further, any substantial change to the makeup of the group, such as a change in the Member demographics, that impacts the underwriting risk of the plan may immediately result in a change to the plan.  At renewal, if you do not call the IUPAT VIP administrative office to re-enroll or discontinue coverage, you hereby authorize and give permission to the IUPAT VIP administrative office to auto-enroll you in the renewal plan benefits that most resemble your currently elected benefits. Auto-enrollment could result in a potential increase in your monthly or bimonthly premium drafts. Please understand, this is intended to ensure no Member loses coverage for failing or forgetting to take the time to renew or re-enroll. Given that all benefits are “Voluntary” you can cancel or lower your coverage at any time.

Refund Policy: At IUPAT VIP, it is the Member’s obligation to promptly notify us of any changes in status that affect your membership or employment associated with the union. This includes, but is not limited to, resignation, dismissal or termination of employment, layoff, retirement, disability, FMLA leave, leave of absence, military leave, leaving the union, cessation of full union dues payments, improper enrollment, or any other form of separation that prevents active membership in the union or active employment with your employer connected with the union.

• Members must provide this notification within 90 days of the qualifying event to be eligible for a refund of insurance premiums. Notifications received within this 90-day period will result in a refund of the insurance premiums paid, minus all technology and transaction fees, which are non-refundable.
• Members who improperly enroll are subject to the same refund policy rules. Improper enrollment includes, but is not limited to, providing inaccurate information, failing to meet membership requirements, failing to meet work requirements, failing to meet employment requirements, or violating union membership policies.
• Any notification submitted after the 90-day window will result in the forfeiture of any refund. However, refund requests received after 90 days may be reviewed on a case-by-case basis if unforeseen circumstances prevented timely notification.
• It is the sole responsibility of the Member to ensure that notifications are submitted within the allotted 90-day period following any qualifying event. Failure to do so will result in the loss of eligibility for a refund of insurance premiums.
• All transaction and technology fees are non-refundable.

To submit a notification or for any questions regarding this policy, please contact the IUPAT VIP Customer Service Center at (224) 357-7880 or email info@unionone.com.

Failure to Make a Payment: Participating Members for whatever reason may miss a premium payment from time to time. The current plan allows for a 60-day grace period to make up any missed premium payments.

Administrative and Transaction Costs: All administrative and transaction fees are included in your monthly costs. These include a $2 technology fee included in all Short-Term Disability and Long-Term Disability monthly costs, as well as a $1 technology fee included in all Member Life and Spouse Life monthly costs. These fees cover the costs associated with, but not limited to, premium processing, premium returns, postage, policy correspondence, claims advocacy and other ancillary expenses associated with the administration of your elections. These monthly fees are applied to all coverages shown on the Summary of Benefits & Rates. Additionally, every time a payment is collected there is a Payment Transaction Fee of $1.00.

By E-signing, I acknowledge that I understand and agree to all the above statements.  The above requirements may change over time and do not supersede the group policy booklet.