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Complete a Bi-Annual Statement

In March of every other year, the Pension Fund mails a Bi-Annual Statement to each Pensioner and Beneficiary whose pension was effective prior to January 1st of the same year.

When you receive your Statement, you are urged to complete and return it as soon as possible. A delay could affect your future benefit payments.

What is an Annual Statement?

Every other year, the Pension Fund asks each Pensioner and Beneficiary to certify that he is the person actually receiving and endorsing the checks and that he continues to satisfy the Plan’s requirements for a pension benefit. The purpose of the Statement is to insure that individuals receiving monthly benefits are still entitled to those benefits. This not only protects the assets of the Fund, but protects you, the Plan Participant. It’s your money and should only be paid out in accordance with the rules of the Plan.

How to Complete an Annual Statement

Depending on the type of pension benefit you were awarded, you will be asked to complete and return one of the following Statements. The instructions appearing in this article are only a summary of those printed on the actual Statement. It is, therefore, important that you read and follow the instructions printed on the Statement.

  1. SSA DISABILITY - If you are a Disability Pensioner, receiving Social Security benefits, you are asked to return the Statement along with a letter from the Social Security Administration stating you are still receiving a “Social Security Disability” benefit. The letter from Social Security must state you are receiving “Disability Benefits”; otherwise, it will be returned as incomplete. A copy of your Social Security check cannot be accepted as proof of a Social Security Disability benefit.
  2. FUND DISABILITY - If you are a Disability Pensioner, not receiving Social Security benefits, sign the Statement authorizing release of medical information. Have your physician complete the “Doctor’s Statement” on the reverse side, certifying your continued disability.
  3. BENEFICIARY - If you are a Beneficiary, complete the Statement indicating you are receiving and personally endorsing each benefit check. Your signature must be witnessed before a Notary Public, Union Official, or Fund Representative. Important: You must sign the document in the presence of a witness; do not sign it beforehand.
  4. CONSERVATOR - If you are receiving a pension benefit on behalf of a mentally or physically incapacitated Pensioner, you should complete the Statement certifying that the pension checks are used for the maintenance and support of the Pensioner. Sign the Statement before a Notary Public.
  5. PENSIONER - As a Pensioner (other than 1, 2 or 4 above), you are asked to complete the Statement indicating whether you were employed during the previous year. If so, you should complete the reverse side of the Statement, listing all of your employment activities for the year. Sign the Statement before a Notary Public, Union Official, or Fund Representative.

What happens if I don’t return the Statement?

If we don't receive your Statement by May 31st, we will not release future monthly benefit checks, beginning with your June benefit payment.

If we don’t receive your Statement by August 31st, your Pension will terminate, as well as, health and welfare coverage if you have this coverage.

Pension and health and welfare benefits may be reinstated once we receive a completed Statement.

IMPORTANT - To avoid a delay or termination of your pension, remember these simple steps:

  1. Read and follow the instructions.
  2. Complete and sign the Statement.
  3. Return the Statement as soon as possible.
Copyright ©2003; Laborers Funds Administrative Office of Northern California, Inc. All rights reserved.
Derechos Reservados Propiedad Literaria ©2003, La Oficina Administrativa de Fondos de los Obreros del Norte de California, Inc.