Role of Trustees

Role of Trustees

 

The Board of Trustees are Union Members who are appointed to oversee the overall operation and administration of the Union Disability Benefit Plan. Their role is to ensure that:

  1. The Plan remains financially sound; and account for the handling of the Funds.
      
  2. The Insurance Contract is administered correctly, consistently, and fairly to all Members. Benefits, of course, may only be paid in accordance with the eligibility requirements of Benefit Plan. The Underwriting Group Insurance Company sets out the Policy requirements concerning the amount and timing of benefits, and, most importantly, the criteria for eligibility.
      
  3. To represent the Members when Claims are Contested or a request is received for a File Review.
     
    Reviews are done Quarterly at the Board of Trustees Meeting with the Plan Administrator.
      
    - if a Member provides authorization for the Board of Trustees to review all Medical and other documentation on file for Short Term Disability, then the complete file will be reviewed to ensure that all steps have been taken to allow for the fair assessment of the Claim. At this point, the Trustees may request: the Plan Administrator write for additional Medical information; the Medical Consultant contact the treating Doctor directly; the Claim be paid extra-contractually; etc.
      
    Usually when a claim is paid extra-contractually the Underwriting Insurance Company must be involved. As well, the Board needs to be mindful of not setting a precedent.
      
    - if a release of Medical information is not given to the Board of Trustees, they will review the handling of the file. The Plan Administrator will provide a synopsis of the Claim to show the workflow only if requested by the Board. Medical will not be provided in this instance. If the Board of Trustees do not feel that the claim was handled fairly, recommendations will be made.
      
    - it is of utmost importance that a prudent decision be made, given that the Trustees are ultimately responsible for the administration of the Fund. The necessity of attending meetings cannot be overemphasized. At the very least, it may be said that a Trustee who is not in attendance of the Board of Trustees regular scheduled Meetings is as responsible for the decisions made as are those in attendance; and as such, liable for the consequences thereof.
      
  4. Representatives of the Underwriting Insurance Company join the Quarterly Board of Trustees Meetings, when held in the Plan Administrator's Office, to discuss Long Term Disability (LTD) Claims. If a Member feels they are being treated unfairly, the Board will discuss the handling of the LTD claim to ensure that all contractual obligations have been met by both the Insurance Company and by the Member. If other options are available to expedite a Member's claim or to provide proof of Total Disability, the Board of Trustees will discuss these with the Plan Administrator and the Insurance Company as to their feasibility.
      
    The Insurance Carrier adjudicates all Long Term Disability claims. Neither the Board of Trustees nor the Plan Administrator can change the decision made by Long Term Disability Underwriting Insurance Company administering the LTD Plan. There must be medical acceptable to the Insurance Company, to support the claim and the Member is given the avenues to follow when their LTD claim is declined for benefit payment. The Trustees can review the LTD file with authorization from the Member, noting that they are just reviewing the file to ensure fair, equitable treatment. If there is medical of which the Trustee is aware and it is not on file, the Trustees can follow-up on this matter but the final LTD decision is with the Insuring Underwriting Company.
      
    When the LTD claim is declined by the present Insurer (Manulife Financial, June 2005), the Member is usually invited to submit further medical documentation to Manulife’s Toronto, Ontario office for further review. The address of this office is provided. If the Member does not have further medical to submit, the Member is advised that they have the opportunity to Appeal the claim's decision to Manulife's head office, and this address is provided in the letter to the Member.
      
  5. One of the Board of Trustees' responsibility is to negotiate The Disability Policy terms and benefit levels with the Insurance Company, in consultation with the Plan Administrator, Canadian Benefits Consulting Group Ltd.. The Plan Administrator is employed by the Board of Trustees to assist in all areas of administration including Short-Term Disability payment and Policy renewal consulting services.
      

Trustees are not compensated for time in administering their Plan. Unquestionably, the role of the Trustee to a Trust Fund is at the same time a rewarding and challenging experience. They make themselves available to Members on Disability and intercede on their behalf when necessary, and/or represent the Member when the Member requests that his claim file be reviewed for ongoing disability benefits. However, as with any other assignment, there are duties and obligations upon the Trustees and the law requires that the Board of Trustees perform his/her duties in the manner contemplated by law.

  

  

lc: en Role of Trustees - June2005