Insurance Fund

2023 1095B Forms for Insurance Coverage

Beginning in the 2019 tax year, the federal penalty for failing to enroll in health insurance was discontinued. Accordingly, individual tax payors no longer have to report or certify on their federal returns whether they had health insurance during the tax year and do not need this form.

Because of this change we no longer mail 1095B forms to all participants. However, participants may receive a copy of their 2020 Form 1095-B on request, accompanied by an e-mail address and a physical address to which a request may be sent, as well as a telephone number that employees can use to contact the reporting entity with any questions. Please contact the Fund Office for more information.

About the Insurance Fund

Name of Fund

Roofers’ Local No. 33 Insurance Fund

Address of Fund

53 Evans Drive
P.O. Box 9106
Stoughton, MA 02072

Employer Identification Number / Fund Number

04-6148460 / 501

Fiscal Year of the Fund (Fund Year)

January 1 through December 31

Plan Sponsor

Roofers Local Union No. 33 and participating employers established and maintain the Fund. Participants of the Fund can receive from the Fund Office, upon written request, information as to whether a particular employer or employee organization is a sponsor of the Fund. If the employer or employee organization is a sponsor of the Fund, the Fund Office will provide the sponsor’s address. Pursuant to ERISA, the Board of Trustees is considered to be the Plan Sponsor.

Type of Administration of the Fund

The Fund is administered and maintained by a joint Board of Trustees currently consisting of three Union Trustees and three Employer Trustees. The Board of Trustees is governed by the Trust Agreement established and maintained in accordance with Collective Bargaining Agreements.

The Fund Office currently handles the day to day administration of the benefits under this Plan, including your medical and hospitalization benefits, on behalf of the Trustees. Most benefits under the Fund are self-insured. Some, including life insurance coverage, are purchased from insurance companies (these are referred to in this SPD as “insured benefits”).

Medical Benefits
Prescription Drug Benefits
Dental Benefits
Vision Benefits
Loss of Time Benefits
Life Insurance Benefits
AD&D Benefits

We all recognize the need for a comprehensive personal medical coverage program that provides hospital, doctor, prescription drug, vision care, and dental benefits. It is also important to have continuation of income during periods of total disability, and Life Insurance.

However, many of us would find the costs of such coverage beyond our financial means if we had to pay for all of it, individually. The Trustees are pleased to be able to provide these benefits to you and your family through the Insurance Fund.