Northwest Carpenters Health and Security Plan

Administrative Information

a. Plan Name

The plan is known as the Northwest Carpenters Health and Security Plan. This plan booklet describes benefits available to participants and their dependents.

b. Name, Address and Telephone Numbers of the Joint Board of Trustees

The plan is sponsored by a joint labor-management board of trustees. The Board’s name, address and telephone number are:

Board of Trustees
Northwest Carpenters Trusts
2200 Sixth Avenue, Suite 300
Seattle, WA 98121-1839
(206) 441-6514 Seattle Area
(800) 552-0635 Nationwide

Click for a list of Trustees.

You and your dependents may obtain a complete list of the employers and employee organizations sponsoring the plan by written request to the Trustees. You may also examine this information at Northwest Carpenters Trusts or your Local Union upon ten days advance written request. The Trustees may impose a reasonable charge to cover the cost of furnishing these lists, and you may wish to ask the amount of the charges before requesting copies.

c. Identification Number

The Internal Revenue Service employer identification number assigned to your plan is 91-6029049. In accordance with IRS instructions, the Trustees have assigned this plan the identification number of 501.

d. Type of Plan

The Northwest Carpenters Health and Security Plan is a welfare plan which provides medical, surgical, hospital, prescription, vision, dental, time loss, life insurance, and accidental death and dismemberment benefits.

e. Type of Administration

The plan is administered by a joint labor-management board of trustees with the assistance of a salaried administrator.

f. Name, Address and Telephone Numbers of the Salaried Administrator

Gene H. Price
Northwest Carpenters Trusts
2200 Sixth Avenue, Suite 300
Seattle, WA 98121-1839
(206) 441-6514 Seattle Area
(800) 552-0635 Nationwide

g. Description of Collective Bargaining Agreements

The plan is maintained according to the terms of the Trust governing the Northwest Carpenters Health and Security Plan and the applicable collective bargaining agreements. You and your dependents may obtain a copy of an agreement by writing to the Trustees. You may also examine an agreement at Northwest Carpenters Trusts or your Local Union upon ten days advance written notice. The Trustees may impose a reasonable charge to cover the cost of furnishing an agreement and you may wish to ask the cost before requesting copies.

h. Eligibility and Benefits

You are entitled to participate in this plan if you work under a collective bargaining agreement described in item G above or a written contribution agreement, and if your employer makes contributions to the Trust Fund on your behalf. The eligibility rules which determine which participants and dependents are entitled to benefits are located here. Click for suspension of eligibility and termination of coverage rules. The benefits to which participants and dependents are entitled are listed here. If you do not have your own copy of the printed booklet, contact Northwest Carpenters Trusts at the address in item B, or your Local Union. There is no charge for them.

i. Source of Contributions

The Northwest Carpenters Health and Security Plan is funded by employer contributions. The amount of these contributions is specified in the collective bargaining agreements described in item G above or a written contribution agreement. Self-payments are also permitted for continuation coverage. Continuation coverage under Self-Contribution Coverage, COBRA Coverage and Retiree Coverage. Procedures for filing claims are described here.

j. Entities Used for Accumulation of Assets and Payment of Benefits

Contributions paid into the plan to obtain benefits are received and held in trust by the Board of Trustees, pending payment of benefits, administrative expenses, and insurance premiums to designated insurance companies.

The Board of Trustees pays benefits directly from the Trust Fund, with the exception of life insurance and accidental death and dismemberment benefits and any other insurance company identified in the plan’s 5500 filed with the U.S. Department of Labor.

k. Plan Year

January 1 through December 31.

l. Agents for Legal Process