Benefits Available When You Are Disabled

Take advantage of this important benefit when you cannot work.

If you are the employee participant, have worked for your employer for more than 12 months and are unable to work due to total disability (for your own non work-related illness or injury), you may qualify for weekly disability benefits provided by the Trust for up to 26 weeks. Receiving this weekly disability benefit may also extend the health plan coverage you had prior to your disability for up to three months under the premium waiver provision of your plan. Without this benefit, you may not continue to qualify for your health plan coverage during your inability to work.

To qualify for benefits, you must 1) be under the continuous care and treatment of a physician or certain covered providers on or after the date of the disability and 2) your disability must be supported by medical evidence. The benefit amount ranges from $180 to $300 per week and is based on 80 or more hours of employment and total gross monthly wages in the two months before you become totally disabled and stopped active work. (For example, if you’re totally disabled in July, the weekly benefit is based on employment hours in May.)

TO SUBMIT A CLAIM:

  1. Obtain a weekly disability (time loss) claim form online atsoundhealthwellness.com or by calling the Trust Office (number below).
  2. Complete part 1 of the form in its entirety and remember to sign and date the form.
  3. Have your physician completely fill out, sign and date part 2 of the form (if you are seeing multiple physicians for your condition, each one should fill out a separate form).
  4. Have your employer completely fill out, sign and date part 3 of the form.
  5. Mail the fully completed form to the address at the top of the form or fax both sides of the completed form to (206) 285-4437.

Please refer to the Employee Weekly Disability (Time Loss) Benefit and the Eligibility While Disabled (“Premium Waivers”) sections of your Summary Plan Description (SPD) for full details.

If you have questions about these benefits, please call the Trust Office at (206) 282-4500 or (800) 225-7620 option 2 then option 1.

IMPORTANT NOTE: Once you return to work, you need to be sure to notify the Trust Office at  (206) 282-4500 or (800) 225-7620.