You will become eligible in Minneapolis Retail Meat Cutters and Food Handlers (MRMC) Health and Welfare Plan (the “H&W Plan”) the first day of the calendar month following the calendar month the Fund receives contributions on the employee’s behalf.
Your coverage options will be subject to your job classification and your
UFCW Local 663 Collective Bargaining Agreement. Check your applicable CBA for more information.
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Full Time: You are eligible for family coverage. Depending on your employer, you may be able to select a coverage tier (Single, Single + Spouse, Single + Child(ren), and Family.
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PT Mod: Most employers only fund the Single tier for PT Mod participants. You are able to “buy up” to add dependents at an additional cost on your weekly premium.
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Other PT classifications: You may be eligible for Ancillary coverage. See the question below for more information.
Employee cost share amounts can be found in your applicable CBA or the contribution rate summary.
Ancillary benefits generally refer to a limited benefit package (e.g., certain dental/vision/life/AD&D and telehealth), typically for eligible part-time classifications. Consult your
UFCW Local 663 Collective Bargaining Agreement to see if Ancillary Benefits are an allowable election.
The
Summary Plan Description defines eligible dependents and includes categories such as spouse and children under age 26, with additional rules for disabled dependents and certain other child relationships (stepchildren, adopted, foster, etc.).
Generally, children can be covered until age 26, and disabled children may be eligible beyond age 26 if Plan requirements are met and proof is provided.
No, parents and other relatives are not eligible for dependent coverage, even if supported by the Employee.
Eligible dependents of full-time employees become eligible the first day of the month after the employee becomes eligible, and new dependents acquired later (marriage, birth, adoption) may be covered as of the date they become a dependent when timely requested. To enroll a dependent, complete a
Family Update Form and provide any required documentation, such as a birth certificate, adoption papers, or marriage certificate, as soon as it is available.
Yes, you can opt out of coverage. If you choose to re-enroll in the Plan, you will need to meet the eligibility requirements before being allowed to resume coverage.
You may be able to change coverage due to a qualifying event such as marriage, birth, adoption/placement for adoption, or loss of other coverage, but you must request enrollment within the applicable deadline.
Currently, Open Enrollment is guaranteed to be available for the entire month of September. The Board of Trustees may extend eligibility outside of this period at their discretion. You may adjust your elections as many times as you like ahead of Open Enrollment close.
The
Summary Plan Description generally provides 30 days to request enrollment after marriage/birth/adoption or loss of other coverage.
Yes, an employee can pay a weekly contribution rate to continue coverage in certain situations. The
Fund Office will contact you when an employee portion of the contribution rate is needed.
COBRA is a continuation option when coverage is lost due to qualifying events like reduction in hours, termination of employment (except gross misconduct), divorce/legal separation, death, or a dependent aging out.
The
Summary Plan Description describes continuation periods that can be up to 18 months for certain events, up to 29 months in disability situations, and up to 36 months for certain dependent-related qualifying events.
You generally have 60 days from coverage termination or receipt of the COBRA notice (whichever is later) to elect continuation coverage.
Contact the
Fund Office and ask to speak with an Accounts Receivable (AR) Specialist. They will verify eligibility and request a new card. Your new card will arrive within 7-10 business days from the date you first notify the Plan that you need a new card. You can also access a virtual copy of your ID card on the UMR app or website.
You will receive your medical cards 7-10 business days from the end of the month, following receipt of the required number of weekly contributions to be eligible for benefits.
Contact the
Fund Office and speak with an Accounts Receivable (AR) Specialist. They will confirm your eligibility and send a packet.
If you would like to access your EOBs, please visit the
UnitedHealthcare/UMR website. Once on the website, you will need to login to your account to access your EOBs.
UHC Broad PPO Choice Plus
No. However, if you utilize an out-of-network provider you and the Fund may pay more.
When you receive services from a participating provider (
UnitedHealthcare/UMR or
Delta Dental), the provider will submit your claim to the Plan. If you receive services from a non-participating provider, you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider then complete an
Initial Report of Claim Form. Forward the bill and completed form by mail, fax, or e-mail.
If you receive a bill, first verify whether the provider is in network. If assistance is needed, contact the
Fund Office before submitting payment.
If you receive services from a non-participating provider, you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider then complete an
Initial Report of Claim Form. Once completed, send form and bill to the address as it appears on the claim form.
A copay (copayment) is a fixed, out-of-pocket dollar amount you pay at the time of visit:
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$25 for a standard doctor’s visit
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$50 for a specialty doctor’s visit
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$250 for an emergency room visit
A deductible is the specific amount of money you pay out-of-pocket for covered insurance services before your insurance company begins to pay. Once you meet this amount, insurance kicks in for the remaining covered costs.
As of 1/1/2026, the deductibles are:
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$500 per person per year
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$1,500 per family per year
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$25 deductible for dental benefits per year
Coinsurance is the percentage of costs a policyholder pays for covered healthcare services after meeting their annual deductible, while the insurance company pays the remainder. For many services, the Plan’s coinsurance is 80%, which means that you would be responsible for 20% of the costs incurred, up to the annual out-of-pocket maximum.
As of January 1, 2026, the annual out-of-pocket maximum per calendar year is:
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$2,500 per Eligible Person
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$5,000 per Family
An out-of-pocket maximum is the most you will pay for covered, in-network health services in a plan year, including deductibles, copayments, and coinsurance. Once this limit is reached, your insurance plan pays 100% of covered, medical expenses for the rest of the year. It does not include your weekly premiums.
This is separate from your Prescription Drug annual out-of-pocket maximum.
Yes. There is a $25 co-pay, then the Plan pays 80% for a maximum of 20 visits per person per year. No benefits are payable for services that are work-related, auto related, or involve third-party liability.
Preventive care is covered 100% by the plan, but services done to diagnose or treat a condition may be processed as diagnostic and subject to cost-sharing.
If additional services are provided (lab work, imaging, or problem-focused evaluation), they may be billed as diagnostic rather than preventive and may have cost-sharing. It is recommended to call the
Fund Office if you have any questions or concerns.
Telehealth is the use of digital information and telecommunication technologies (computers, smartphones, video, apps) to access health care services remotely rather than in a provider's office. Teladoc, a Telehealth provider, is covered at 100%. You can view the
Teledoc Flyer for more information.
Yes, ancillary Teladoc instructions state you pay per visit and then submit your receipt for 100% reimbursement. You can request reimbursement by forwarding your itemized bill and
Initial Report of Claim Form by mail, fax, or e-mail.
The Plan will pay 80% and you will be responsible for the other 20%. In some instances, you may need to submit an
Initial Report of Claim Form.
You can use any retail pharmacy to have your prescription filled; however, if you use an
Evernorth (Formerly ExpressScripts) retail pharmacy, such as Cub, Walgreens, or Thrifty White, or the mail-order program, you will save money.
If you have a prescription filled at a non-network retail pharmacy, your medication will not be discounted. In addition, if you have prescriptions filled at a CVS, Wal-Mart, Target, Hy-Vee, Sam’s Club, Costco, or Coborn's retail pharmacy, you will be responsible for 100% of the cost of the medication.
There is no deductible for pharmacy benefits.
Coinsurance is the percentage of costs a policyholder pays for covered healthcare services after meeting their annual deductible, while the insurance company pays the remainder. For many services, the Plan’s coinsurance is 80%, which means that you would be responsible for 20% of the costs incurred, up to the annual out-of-pocket maximum.
If you use an out-of-network pharmacy, you will be responsible for 100% of the cost of the medication.
As of January 1, 2026, the annual pharmacy out-of-pocket maximum per calendar year is:
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$3,600 per Eligible Person
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$7,200 per Family
An out-of-pocket maximum is the most you will pay for your prescriptions in a plan year. Once this limit is reached, your insurance plan pays 100% of covered medical expenses for the rest of the year. It does not include your weekly premiums.
This is separate from your Comprehensive Major Medical annual out-of-pocket maximum.
Step therapy means you may need to try a clinically appropriate, lower-cost medication before a higher-cost medication is approved. Call the
Fund Office if you have any questions or concerns.
Specialty drugs are high-cost, high-complexity prescription medications used to treat chronic, rare, or complex conditions like cancer, rheumatoid arthritis, or multiple sclerosis. They often require special handling (refrigeration), unique administration (injections/infusions), and intensive patient monitoring. These drugs are typically managed through specialized pharmacies.
Yes. Active employees and their adult dependents are entitled to reimbursement up to the limits stated below:
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Routine vision exam: One exam per eligible person or covered dependent child is 100% covered per calendar year
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Frames: Up to $70 per calendar year
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Single lenses: Up to $74 per calendar year
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Bifocal lenses: Up to $128 per calendar year
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Trifocal lenses: Up to $156 per calendar year
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Lenticular lenses: Up to $280 per calendar year
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Contacts: Up to $87 per calendar year (in lieu of all other lens and frame benefits)
For dependent children under the age of 19, the Plan allows 100% coverage for one set of lenses per calendar year.
Please note that most vision providers will ask participants to pay upfront. You can request reimbursement by sending an
Initial Report of Claim Form, along with proof of payment to the
Fund Office by mail, fax, or e-mail.
Vision benefits are available through the Comprehensive Medical benefits: UHC Choice Plus Network.
When you receive services from a participating provider, the provider will submit your claim to the Plan. If you receive services from a non-participating provider, you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider then complete an
Initial Report of Claim Form. Forward the bill and complete form to the address as it appears on the form.
Dental care benefits are available for all plan participants and dependents (if applicable).
The Plan pays up to a maximum of $2,000 for each Covered Individual each calendar year. After you reach this annual maximum, you are responsible for 100% of the costs.
Yes, there is a deductible of $5 per eligible person per calendar year for restorative and prosthetic services (including oral surgery).
Coinsurance is the percentage of costs a policyholder pays for covered healthcare services after meeting their annual deductible, while the insurance company pays the remainder. For Diagnostic and Preventive Services, the Plan pays 100% up to $2,000 dollars in a calendar year. For Restorative Services, the Plan pays 80%, up to $2,000 in a calendar year. For Prosthetic Services, the Plan pays 80%, up to $2,000 in a calendar year. The Plan will not pay more than $2,000 in a calendar year across all services listed.
Yes, Orthodontics are covered. The Plan will pay 50% coinsurance, up to $1,500 in a lifetime. Orthodontics services are only available for Eligible Dependents between ages 8 to 18.
Yes, the Plan provides weekly disability income benefits for eligible employees (per Plan rules).
Weekly disability benefits are only available to full-time eligible employees.
The Plan pays 60% of your Average Weekly Wage, up to a $300 maximum per week, for up to 26 weeks.
“Total Disability” means a condition that prevents you from performing your regular occupation (and must be verified periodically by your physician).
Yes. The Plan includes life insurance benefits for eligible employees based on classification.
Current 2026 materials show $25,000 for full-time employees and $10,000 for part-time employees.
Yes, full-time employees can receive $2,000 for a spouse and $2,000 for eligible dependent children (age rules apply).
AD&D benefits are available for eligible part-time employees only, with a $1,000 principal sum in current Plan materials.
Beneficiaries should contact the
Fund Office as soon as possible for the correct claim form and required documentation.
The EAP provides confidential assessment, short-term counseling, and referral services to help with personal concerns that can affect life at work and at home.
TEAM is the current EAP and has in-person and virtual services.
The EAP is available to all participants of the Plan.
TEAM can assist with stress, relationship/family problems, grief, workplace concerns, and alcohol/substance use, and can refer you to community resources or ongoing support if needed.
Yes.
TEAM includes work-life support such as childcare and elder care referrals and legal and financial resources.
Call (651) 642-0182 or (800) 634-7710, or visit the
TEAM website.
Yes,
TEAM is confidential and counselors are available to speak in confidence.
An EOB explains how a claim was processed and what you may owe; it is not a bill, but you should compare it to any provider bill you receive.
The
Summary Plan Description includes specific claim filing timelines and requirements. Late claims may be denied, so submit as soon as possible after the date of service.
Some services require review or approval before they are covered; the
Summary Plan Description outlines when pre-service rules apply and how the Plan reviews them.
Claims can be denied for a variety of reasons, including reasons such as: the service wasn’t covered under the Plan, required prior authorization was not obtained, eligibility was not active on the date of service, the provider billed incorrectly, or the wrong diagnosis/service code was used, the claim was filed after the plan’s deadline, or additional information is needed (medical records, itemized bill, coordination of benefits, etc.).
If your claim is denied, review the Explanation of Benefits (EOB) for the denial reason and next steps. If you still have questions or need help with an appeal, contact the
Fund Office.
The
Summary Plan Description describes the internal appeal process (including deadlines) and, when applicable, the external review process after internal appeals are exhausted.
To change your mailing address, you must complete a
Change of Address Form and mail it to Wilson-McShane. You may also contact the
Fund Office if you need a form mailed to you.
Your natural child is eligible for coverage on the date of their birth. If you adopt a child, have a child placed with you for adoption, or acquire a stepchild through marriage, they will be eligible for coverage on the date of placement or marriage, as long as you are responsible for healthcare coverage and your child meets the Plan’s definition of a dependent child.
You must enroll your child for coverage before the Fund pays benefits. To enroll your child, complete a
Family Update Form and provide any required documentation, such as a birth certificate, adoption papers, or marriage certificate, as soon as it is available. Once your child is enrolled, benefits will be paid retroactively to the date of the birth, placement for adoption, or marriage.
If you are eligible for Family coverage, an eligible employee’s child will be eligible for coverage under the Plan, at least on a secondary basis, until the child’s 26th birthday.
When adding a spouse or domestic partner, you must notify the
Fund Office within 30 days of the date of your marriage/domestic partnership for them to be covered under the Plan. Complete a
Family Update Form, attach a copy of your marriage/domestic partnership certificate and mail or email them to the
Fund Office. If this information is received within 30 days of the date of your marriage, your spouse/domestic partner’s effective date will be the date of the marriage/domestic partnership.
Following your change in status, your Employer will notify the
Fund Office. This will qualify you to make changes to your health insurance elections outside of the annual Open Enrollment window. The
Fund Office will then send you a notice by email and also by mail. You may make your elections by logging into your account.
Your new elections and/or coverage will begin on the first day of the first month following the month in which the
Fund Office receives your elections. Example: If you were promoted from PT to FT on February 1 and you enroll in family coverage on February 15, your family coverage would start on March 1.
Coverage terminates at the end of the month following the last lag month contributions are due. Consult your
UFCW Local 663 Collective Bargaining Agreement for specifics related to PTO contributions paid after termination. At this point, a COBRA notice will be sent by Wilson-McShane Corporation notifying you that your coverage has been terminated. You may continue coverage through COBRA for up to 18 months.
Contact the
Fund Office and ask to speak with an Accounts Receivable (AR) Specialist. You may also check your eligibility by logging into your account and viewing your “Health & Welfare – Eligibility.”
First, contact your employer to fill out the required FMLA and/or MN PFML paperwork. Then, contact the
Fund Office with any additional questions.
If you are not working due to a non-occupational injury or illness, your Health Coverage may continue for up to 12 weeks through applying for FMLA with your employer. Note: FMLA is an option assuming your employer is subject to the FMLA and makes the required contribution and files the appropriate notification and certification forms with the
Fund Office.
Additionally, if you are a Full-time Employee and become totally disabled after becoming covered under the Plan, are under a physician’s care, and you are unable to work because of a non-occupational injury or illness, you may be entitled to Weekly Disability Income Benefits. Benefits begin on the first day of an accidental injury or the eighth day of an illness. You will need to complete the front page of the
Initial Disability Form, have your physician complete the back side, and submit it to the office. As long as you remain disabled, the Plan will pay up to 60% of your wages for up to 26 weeks. The weekly maximum weekly amount is $300.
If you are a full-time employee, but your hours are reduced to part-time levels, you may not experience any disruption in coverage. However, if your employer reclassifies you to part-time,, you may experience changes in member premium responsibility. Consult your
UFCW Local 663 Collective Bargaining Agreement for specifics related to changes in job classifications.
If you and your spouse get a divorce or legal separation, your spouse will no longer be eligible for coverage. Your spouse may elect to continue coverage under COBRA for up to 36 months upon divorce or legal separation. You or your spouse must notify the
Fund Office within 60 days of the divorce or separation date for your spouse to obtain COBRA continuation coverage. You must also submit a copy of the divorce decree to the
Fund Office. If you have children for whom you do not have custody, a copy of any Qualified Medical Child Support Order (QMCSO) is also required. At this time, you may also want to review your beneficiary designation for your Life and AD&D Insurance, if eligible.
The above information is applicable to termination of domestic partnerships.
If you are not eligible for Medicare, your only option is to continue coverage through COBRA for 18 months or contact a health care provider to enroll in a healthcare program. If you are eligible for Medicare, you can go on the BCBS Senior Gold Plan through the Plan or contact a health care provider to enroll in an individual Medicare supplemental plan.
Dependent Children not eligible for Medicare may continue Plan coverage through COBRA for up to 36 months from your retirement.
Your dependents may continue coverage for up to 36 months by electing COBRA continuation coverage. It is recommended that you provide any beneficiaries and/or dependents information to contact the
Fund Office in case you should unexpectedly pass.
The Health Reimbursement Arrangement (HRA) is an individual account the Fund created as part of its modernization process for active participants who had unused grace weeks as of December 31, 2024, and it can be used to pay for permissible health-related expenses. For some employers, UFCW 663 bargained additional continuing contributions for eligible workers. Consult your
UFCW Local 663 Collective Bargaining Agreement for more information.
The Fund changed eligibility rules so coverage continues through the end of the second month after covered employment ends, grace weeks are no longer needed to extend coverage, and the Fund recognized the value of unused grace weeks by making a one-time contribution to a new HRA account.
You can read more in the Grace Week Conversion to HRA FAQ.
HRA-eligible expenses are generally those allowed under IRS Code Section 213(d), which can include many medical, dental, and vision expenses, prescriptions, certain eligible over-the-counter items, Health Fund premiums, and copayment. You may also reference the
IRS Eligible Medical Expenses.
You can use your HRA by submitting an
HRA Claim Form, with required documentation, or by using the
HRA Debit Card for eligible expenses (additional documentation may still be required).
Most providers will accept the HRA debit card, but if a provider does not, you can still request reimbursement by filing a claim through the online portal, mobile app, or paper claim process with an itemized statement.
You can check your balance and manage your HRA using the
WEX HRA Benefit Portal or the “MRMC Health HRA” mobile app, and you can also contact the
Fund Office for help.
Fund materials state claims must be filed within 365 days of the date you incurred the expense or within 120 days after you are no longer covered by the Fund, and reimbursements cannot exceed your available HRA balance.
Report a lost or stolen HRA debit card immediately by contacting the
Fund Office at (952) 851-5797.
Sometimes an HRA claim (or an HRA debit card transaction) can’t be approved until the required “proof” is provided. The Fund must have documentation that shows the expense is eligible and was incurred during the allowable timeframe.
Common reasons you may be asked for more documentation include:
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The document submitted is missing required details (for example: date(s) of service, type of expense, provider name, and the amount applied to your deductible/out-of-pocket).
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The wrong type of document was submitted (credit card receipts/statements, provider invoices/bills/statements, or canceled checks are not acceptable.
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An Explanation of Benefits (EOB) is needed (especially when the expense was processed through medical/dental/vision insurance).
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A debit card purchase was flagged as “needs receipt,” and the portal is requesting you upload the supporting receipt/itemized statement.
If you need help, it is recommended to contact the
Fund Office.
All Medicare retirees making retiree self-payments have supplemental insurance through the Senior Gold plan offered by BlueCross BlueShield of MN.
You will need to contact the
Fund Office and inform them of your Medicare eligibility and they will have an enrollment packet mailed to your address.
YES. In order to be eligible to go on the Medicare coverage, you must have both Medicare Part A and Part B. If you do not have Medicare Part B it is crucial that you enroll in Medicare Part B as soon as possible.
You must contact BCBS of MN customer service:
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For medical questions, (800) 531-6686.
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For prescription questions, (844) 838-3827.
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