Test

Health & Welfare

H&W

> Plan C-MRP Family

Plan C-MRP Details

Coverage

Plan C-MRP Family

Coverage Period

10/01/2023 - 12/31/2023

MRP Balance

$2,839.99

Administrative Fee Met

10/19/2021

Enrollment Form Sent

01/01/2023

Lapse

No

Participation Termination

No

Combined Account

No

Forfeitures

No

QMSCOs

No

CAPP Account

Previous Balance:

$8,678.18

October

$175.97

November

$88.00

December

$172.84

Total Contributions

$9,114.99

Admin Fees:

$175.97

Medical Reimbursements:

$88.00

Amount Available:

$172.84

Co-Payment:

$172.84

Premium Payment:

$172.84

Transfers/Waivers:

$172.84

Ending Balance

$8,678.18

Contribution Detail

Transaction Process

10/05/23

13/05/23

10/06/23

Wk End

10/05/23

13/05/23

10/06/23

Posted

10/05/23

13/05/23

10/06/23

Employer/Production

Encore Event Technologies Inc.

Report

4159188

Amount

$175.97

Statement Activity

Coverage Begins

10/05/23

13/05/23

10/06/23

Type

Quarterly

Revised

Date Sent

09/28/2023

Status

Bad Add/Negative Balance

-

Due Date

09/28/2023

Balance

-$17.37

$158.60

Account Actions

Request ID Card(s)

Other Coverages

Request ID Card(s)

Health & Welfare

H&W

> Plan C-MRP Family

> Coverage History

Coverage History

Plan Type

A Family

Plan Type

C-MRP Family

Plan Type

C-MRP Single

Plan Type

C4 Single

Plan Type

C3 Family

Plan Type

C2 Family

Plan Type

C1 Family

Plan Type

A Family

Plan Type

A Family

Plan Type

A Family

Plan Type

C-MRP Family

Plan Type

C2 Family

Effective Date

10/05/23

Effective Date

13/05/23

Effective Date

10/06/23

Effective Date

10/06/23

Effective Date

10/06/23

Effective Date

10/06/23

Effective Date

10/05/23

Effective Date

13/05/23

Effective Date

10/06/23

Effective Date

10/06/23

Effective Date

10/06/23

Effective Date

10/06/23

Termination Date

10/05/23

Termination Date

13/05/23

Termination Date

10/06/23

Termination Date

10/05/23

Termination Date

13/05/23

Termination Date

10/06/23

Termination Date

10/05/23

Termination Date

13/05/23

Termination Date

10/06/23

Termination Date

10/05/23

Termination Date

13/05/23

Termination Date

10/06/23

Health & Welfare

H&W

> Plan A Family

Participant ID

213844

Coverage Status

Plan A Family

Coverage Period

November 2023 - April 2024

Coverage History

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Benefit	Plan Code	Carrier Code	Effective Date	Term/Susp	Reason	Type	Change
Header Welfare	Header A Family	Header Blue Cross Blue Shield	Header 10/05/23	Header 10/05/23	Header	Header	Header 03/22/23-340
Header Welfare	Header A Family	Header Blue Cross Blue Shield	Header 10/05/23	Header 10/05/23	Header	Header	Header 06/15/21-fix
Header Welfare	Header A Family	Header Blue Cross Blue Shield	Header 10/05/23	Header 10/05/23	Header	Header	Header 03/22/09-env

Benefit

Plan Code

Carrier Code

Effective Date

Term/Susp

Reason

Type

Change

Header

Welfare

Header

A Family

Header

Blue Cross Blue Shield

Header

10/05/23

Header

10/05/23

Header

03/22/23-340

Header

Welfare

Header

A Family

Header

Blue Cross Blue Shield

Header

10/05/23

Header

10/05/23

Header

06/15/21-fix

Header

Welfare

Header

A Family

Header

Blue Cross Blue Shield

Header

10/05/23

Header

10/05/23

Header

03/22/09-env

Days Worked

April '23'

19 May '23'

0 June '23'

0 July '23'

0 August '23'

0 September '23'

4 Total Days Accumulated

23

For Coverage: Nov 2023 to April 2024

Eligible

Contribution Detail

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Transaction Process	Ending	Posted	Employer/Production	Report	Unit	Amount	Wkhs
Header 10/05/23	Header 10/05/23	Header 10/05/23	Header Hadestown Broadway LLC	Header 4159188	Header 5.00	Header $ 425.00	Header -
Header 10/05/23	Header 10/05/23	Header 10/05/23	Header Hadestown Broadway LLC	Header 4159188	Header 5.00	Header $ 425.00	Header -
Header 10/05/23	Header 10/05/23	Header 10/05/23	Header Hadestown Broadway LLC	Header 4159188	Header 5.00	Header $ 425.00	Header -
Header 10/05/23	Header 10/05/23	Header 10/05/23	Header Hadestown Broadway LLC	Header 4159188	Header 5.00	Header $ 425.00	Header -

Transaction Process

Ending

Posted

Employer/Production

Report

Unit

Amount

Wkhs

Header

10/05/23

Header

10/05/23

Header

10/05/23

Header

Hadestown Broadway LLC

Header

4159188

Header

5.00

Header

$ 425.00

Header

-

Header

10/05/23

Header

10/05/23

Header

10/05/23

Header

Hadestown Broadway LLC

Header

4159188

Header

5.00

Header

$ 425.00

Header

-

Header

10/05/23

Header

10/05/23

Header

10/05/23

Header

Hadestown Broadway LLC

Header

4159188

Header

5.00

Header

$ 425.00

Header

-

Header

10/05/23

Header

10/05/23

Header

10/05/23

Header

Hadestown Broadway LLC

Header

4159188

Header

5.00

Header

$ 425.00

Header

-

Instructions

Click on contribution period in this “Coverage” column to see the associated work month in the “Days Worked” column. Click the up/down arrows to change the range of work months and the coverage period. Click the work month to see corresponding contributions.

Other Coverages

Request ID Card(s)

Account Actions

Request ID Card(s)

Make Coverage Selection / Co - Payment

Select a coverage option from the offerings below by clicking the applicable box. Failure to male a selection will result in the fund determining your enrollment for the upcoming quarter.

Coverage Options

Your Coverage selection and pay applicable payment is due no longer than 06/17/2024 for the coverege period starting 07/01/2024

Single Family

C1 Single

Amount Owned

$ 799.00

Single Family

C1 Single

Amount Owned

$ 799.00

Single Family

C1 Single

Amount Owned

$ 799.00

Single Family

C1 Single

Amount Owned

$ 799.00

Make CAPP Co-payment

You can select a coverage option from any of the option shown below. Even if you do not owe a co-payment for the co-payment for the coverage you are selecting, you must complete the process by clicking the “Select this Coverage” button. Your Payment is due 12/23/2012 for the coverage period starting 01/01/2013.

Card Type

Cardholder Name

Card Number

Card Expiration Date

CVV

Selected Coverage

Plan C2 Single

Amount Owned

$ 1,086.00

Change Coverage

My Dependents

Dependent Name

Jeff A. Scott

Relation

Spouse

DOB

10/05/1963

Gender

Male

Coverage Effective Date

10/05/2023

Status

Active

Date Of Marriage

10/05/2020

View Details

Add Dependent

Fill the fields with the data of dependent that you want to claim for

What is covered/ Reimbursable?

See List Download Claim Form

First Name

Last Name

Date of Birth

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Relationship

Spouse

Mr

Option 3

Option 4

Eligibility Effective date

Eligibility Term date

Back Add dependent

My Beneficiaries

Fund

Pension

Beneficiary Name

Relationship

Spouse

Type

Primary

%

100.00%

Status

Active

Date Appointed

10/05/2023

QDROe

10/05/2020

Document(s)

View Docs

My Beneficiaries

Diane Factor Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

Allocations for Beneficiaries

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Funds	Level	Percentage	Effective Date	Last Changed	Status
Allocations for Beneficiaries	Edit Assignments
Header Health & welfare	Header Primary	Header 40.00%	Header 01/01/2024	Header 12/19/2023	Header -
Allocations for Beneficiaries	Edit Assignments
Header Annuity	Header Primary	Header 100%	Header 01/01/2024	Header 12/19/2023	Header -

Funds

Level

Percentage

Effective Date

Last Changed

Status

Allocations for Beneficiaries

Header

Health & welfare

Header

Primary

Header

40.00%

Header

01/01/2024

Header

12/19/2023

Header

-

Allocations for Beneficiaries

Header

Annuity

Header

Primary

Header

100%

Header

01/01/2024

Header

12/19/2023

Header

-

Diane Factor Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

Allocations for Beneficiaries

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Funds	Level	Percentage	Effective Date	Last Changed	Status
Allocations for Beneficiaries	Edit Assignments
Header Health & welfare	Header Primary	Header 40.00%	Header 01/01/2024	Header 12/19/2023	Header -
Allocations for Beneficiaries	Edit Assignments
Header Annuity	Header Primary	Header 100%	Header 01/01/2024	Header 12/19/2023	Header -

Funds

Level

Percentage

Effective Date

Last Changed

Status

Allocations for Beneficiaries

Header

Health & welfare

Header

Primary

Header

40.00%

Header

01/01/2024

Header

12/19/2023

Header

-

Allocations for Beneficiaries

Header

Annuity

Header

Primary

Header

100%

Header

01/01/2024

Header

12/19/2023

Header

-

Edit Beneficiary

SSN

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Relationship

Spouse

Mr

Option 3

Option 4

First Name

Last Name

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Suffix

-

Mr

Option 3

Option 4

Date of Birth

Address

Discard Save Beneficiary

Add New Beneficiary

Beneficiary

Name

Sophie A. Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

Name

Sophie A. Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

SSN

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Relationship

Spouse

Mr

Option 3

Option 4

First Name

Last Name

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Suffix

-

Mr

Option 3

Option 4

Date of Birth

Address

Discard Save & Add new Beneficiary

Assign Fund To Beneficiary

Beneficiary

Name

Sophie A. Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

Name

Sophie A. Grant

SSN

XXX-XX-5746

DOB

07/07/1987

Relation

Spouse

Select Fund

Health & Welfare

Assign Fund

Select Level

Primary

Secondary

Tertiary

Assign Fund Percentage

Sophie A. Grant (Child)

50.00%Delete

Eli James Grant (Child)

50.00%Delete

Diane Factor Grant (Spouse)

50.00%Delete

Pension

Assign Fund

Select Level

Primary

Secondary

Tertiary

Assign Fund Percentage

Sophie A. Grant (Child)

50.00%Delete

Eli James Grant (Child)

50.00%Delete

Diane Factor Grant (Spouse)

50.00%Delete

Vacation

Assign Fund

Select Level

Primary

Secondary

Tertiary

Assign Fund Percentage

Sophie A. Grant (Child)

50.00%Delete

Eli James Grant (Child)

50.00%Delete

Diane Factor Grant (Spouse)

50.00%Delete

Annuity

Assign Fund

Select Level

Primary

Secondary

Tertiary

Assign Fund Percentage

Sophie A. Grant (Child)

50.00%Delete

Eli James Grant (Child)

50.00%Delete

Diane Factor Grant (Spouse)

50.00%Delete

Discard

Distribute allocation

Please Distribute 40% allocation of Diane Factor Grant among others beneficiary.

Claims & Re-imbursements

No Claims

Download Claim Form Who is Covered?

New Claim Submission

01

Step 1

02

Step 2

03

Step 3

NOTE: If you wish to have your claim payment directly deposited into your bank account, please submit a completed MRP claims direct deposit form to claims@iatsenbf.org. It may take up to two weeks for processing of your request as we wait for your bank to verify your banking information. Once we receive verification, we can then start to deposit your claims reimbursement payments directly to your bank account. The form can be found in the "Applications/Forms/Documents" link on the Fund website. You can also submit the completed direct deposit form online, in the section where you would normally submit an MRP claim. You can also email it to psc@iatsenbf.org.

What is covered/ Reimbursable?

Download Claim Form

Who is this claim for?

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Select	Name	DOB	Relationship	Eligibility Effective Date	Eligibility Term Date
Header	Header Jeff A. Scott	Header 03/06/1963	Header --	Header --	Header --
Header	Header Jeff A. Scott	Header 03/06/1963	Header --	Header --	Header --
Header	Header Jeff A. Scott	Header 03/06/1963	Header --	Header --	Header --
Header	Header Jeff A. Scott	Header 03/06/1963	Header --	Header --	Header --
Header	Header Jeff A. Scott	Header 03/06/1963	Header --	Header --	Header --

Select

Name

DOB

Relationship

Eligibility Effective Date

Eligibility Term Date

Header

Jeff A. Scott

Header

03/06/1963

Header

--

Header

--

Header

--

Header

Jeff A. Scott

Header

03/06/1963

Header

--

Header

--

Header

--

Header

Jeff A. Scott

Header

03/06/1963

Header

--

Header

--

Header

--

Header

Jeff A. Scott

Header

03/06/1963

Header

--

Header

--

Header

--

Header

Jeff A. Scott

Header

03/06/1963

Header

--

Header

--

Header

--

New Claim Submission

01

Step 1

02

Step 2

03

Step 3

NOTE: If you wish to have your claim payment directly deposited into your bank account, please submit a completed MRP claims direct deposit form to claims@iatsenbf.org. It may take up to two weeks for processing of your request as we wait for your bank to verify your banking information. Once we receive verification, we can then start to deposit your claims reimbursement payments directly to your bank account. The form can be found in the "Applications/Forms/Documents" link on the Fund website. You can also submit the completed direct deposit form online, in the section where you would normally submit an MRP claim. You can also email it to psc@iatsenbf.org.

What is covered/ Reimbursable?

Download Claim Form

Claim Documents

Document-1.pdf

Document-2.pdf

Document-3.pdf

Drag and Drop or Choose From Device

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Comments/Notes (Optional )

New Claim Submission

01

Step 1

02

Step 2

03

Step 3

NOTE: If you wish to have your claim payment directly deposited into your bank account, please submit a completed MRP claims direct deposit form to claims@iatsenbf.org. It may take up to two weeks for processing of your request as we wait for your bank to verify your banking information. Once we receive verification, we can then start to deposit your claims reimbursement payments directly to your bank account. The form can be found in the "Applications/Forms/Documents" link on the Fund website. You can also submit the completed direct deposit form online, in the section where you would normally submit an MRP claim. You can also email it to psc@iatsenbf.org.

Claim History Search

Select parameters below to search for a specific claim or all claims for a specific date range

Claim History Search

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Date Filed	Claim Number	Web Reference	Claim Status	Claim Doc(s)
Header 01/12/2024	Header 2BA449P11462	Header DE656D1350	Header DE656D1350	Header
Header 01/12/2024	Header 2BA449P11462	Header DE656D1350	Header Approved	Header
Header 01/12/2024	Header 2BA449P11462	Header DE656D1350	Header Approved	Header
Header 01/12/2024	Header 2BA449P11462	Header DE656D1350	Header Approved	Header
Header 01/12/2024	Header 2BA449P11462	Header DE656D1350	Header Approved	Header

Date Filed

Claim Number

Web Reference

Claim Status

Claim Doc(s)

Header

01/12/2024

Header

2BA449P11462

Header

DE656D1350

Header

DE656D1350

Header

01/12/2024

Header

2BA449P11462

Header

DE656D1350

Header

Approved

Header

01/12/2024

Header

2BA449P11462

Header

DE656D1350

Header

Approved

Header

01/12/2024

Header

2BA449P11462

Header

DE656D1350

Header

Approved

Header

01/12/2024

Header

2BA449P11462

Header

DE656D1350

Header

Approved

Header

Plan C-MRP

> View/Submit Claim

Information box displaying specific instructions and also the new cliam (web reference_ if implemeted) that would be generated upon submission.

New Claims

Existing Claims

Go To Existing Claim

What is covered/ Reimbursable?

Download Claim Form

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Date Filled	Claim Number	Web Ref.	Claim Status	Claim Doc(s)

No Claims

-

No Claims

-

Work History

Missing Contributions Form

Filters:

Work Period

Option 2

Option 3

All Employers

Option 2

Option 3

All Productions

Option 2

Option 3

Print PDF

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Work Period	Production	Employer	Local	Fund	Work Reported	Credited
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Total Contributions for 2023				Health C Pension C Vacation	87 Hours 9 Days $3000 Gross Wages	$441.09 $441.09 $441.09
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Total Contributions for 2022				Health C Pension C Vacation	87 Hours 9 Days $3000 Gross Wages	$441.09 $441.09 $441.09
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Work Period 03/03/2023 - 03/09/2023	Production The Good Place	Employer 3 Arts Entertainment	Local 336	Fund Health C Pension C Vacation	Work Reported 29 Hours 3 Days $1000 Gross Wages	Credited $147.03 $147.03 $147.03
Total Contributions for 2021				Health C Pension C Vacation	87 Hours 9 Days $3000 Gross Wages	$441.09 $441.09 $441.09
Grand Total Contributions				Health C Pension C Vacation	116 Hours 12 Days $4000 Gross Wages	$588.12 $588.12 $588.12

D= Day(s) Reported, H= Hour(s), Reported W=Week(s), Reported CW= Contractual Wages

Vacation

Participant ID

213844

Reporting Period

01/01/2023 - 12/31/2023

Days Worked

47 Days

Check Destination

Actors Federal Credit Union

Contributions:

$1,482.07 (for year 2024)

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Date

Contributions

Disbursements

Voids

Interest

Admin Fee

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

+

Header

2024

Header

$1,482.07

Header

$0.00

Header

$0.00

Header

$0.00

Header

$0.00

Check Replacement Request

This report is in process.

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Check Type

Vacation

Option 2

Option 3

Option 4

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Type

ACH

Option 2

Option 3

Option 4

Participant ID

First Name

Last Name

Date of Birth

Address for Check Destination currently on File

Address 1

Address 2

Address 3

City

State

ZIP Code

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Notes

Discard Submit

ACH/Check Destination

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Check Type

Vacation

Option 2

Option 3

Option 4

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Type

ACH

Option 2

Option 3

Option 4

Participant ID

First Name

Last Name

Date of Birth

Bank Account Information

Current Banking Information

Bank Name

Bank Address

Routing (ABA)

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Account Type

Checking

Option 2

Option 3

Option 4

Account Number

Repeat Account Number

Beneficiary Name

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Notes

Discard Submit

Annuity Application Request

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Request Type

Select Request Type

Option 2

Option 3

Option 4

Participant ID

First Name

Last Name

Date of Birth

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Notes

Discard Submit

Pension Application

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Request Type

Pension Application

Option 2

Option 3

Option 4

Participant ID

First Name

Last Name

Date of Birth

Anticipated Retirement Date

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Notes

Discard

Pension

> Plan B & C

Total Credits

Vesting Credits:

0.00

Past Service:

0.00

Future Service:

4.30

Pension Credits:

4.30 Key Dates

Year Vested

2015

Participation Date:

01/01/2005

Pension Credit History

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Year

Credited

Worked

Type

Plan

Vesting

Pension

Credited

Earnings

Comments

PR

+

Header

2018

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2018

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2018

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2017

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2017

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2017

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2016

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2016

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2016

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2015

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2015

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

+

Header

2015

Header

75D

Header

75D

Header

F

Header

Plan B/C

Header

1

Header

0.35

Header

$1,000.00

Header

$20,000.00

Header

Participation Date: 1/1/2015

Header

-

Pension

> Pensioner Profile

Demographics

Name

Christina Gillespie

Participant ID

213844

SSN

XXX-XX-5751

Sex

Female

Marital Status

Divorced

Date of Marriage

-

Spouse Name

Jeff A. Scott

Date of Marriage/Divorce

-

Date of Birth

-

Street

914 Pine Street

City

Matenca

State

California

Country

United States

ZIP

95336

Pension Details

Plan

B/C

Type

Normal

Option

60-Month C&L

Retirement

10/01/2022

End Date

-

First Check

11/01/2022

Gross

$1673.45

Net

$1673.45

Payment Destination

Pension Payments on Hold - Please Call Us at 888-XXX-XXXX

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Name	Type	Destination
Header Christina	Header Check	Header Christina Gillespie-Donhue R, 11 Renfrew, Port Monmouth, NJ, 07758-1638

Name

Type

Destination

Header

Christina

Header

Check

Header

Christina Gillespie-Donhue R, 11 Renfrew, Port Monmouth, NJ, 07758-1638

Payment Destination

Pension Payments on Hold - Please Call Us at 888-XXX-XXXX

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Name	Type	Destination
Header James	Header Check	Header Christina Gillespie-Donhue R, 11 Renfrew, Port Monmouth, NJ, 07758-1638

Name

Type

Destination

Header

James

Header

Check

Header

Christina Gillespie-Donhue R, 11 Renfrew, Port Monmouth, NJ, 07758-1638

Estimate Request

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Request Type

Estimate Request

Option 2

Option 3

Option 4

Participant ID

First Name

Last Name

Date of Birth

Anticipated Retirement Date

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Notes

Discard

Pension Contribution History

Filters:

Current Year

Option 2

Option 3

All Employers

Option 2

Option 3

All Productions

Option 2

Option 3

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Production(Multiple)	Employer(Multiple)	Work Period (01/01/2023 - 12/31/2023)	Work Units	Contribution ($)
Header -	Header -	Header -	Header (01/01/2023 - 12/31/2023)	Header -
Header -	Header -	Header -	Header (01/01/2023 - 12/31/2023)	Header -
Header -	Header -	Header -	Header (01/01/2023 - 12/31/2023)	Header -

Production(Multiple)

Employer(Multiple)

Work Period (01/01/2023 - 12/31/2023)

Work Units

Contribution ($)

Header

-

Header

-

Header

-

Header

(01/01/2023 - 12/31/2023)

Header

-

Header

-

Header

-

Header

-

Header

(01/01/2023 - 12/31/2023)

Header

-

Header

-

Header

-

Header

-

Header

(01/01/2023 - 12/31/2023)

Header

-

My Profile

Select parameters below to search for a specific claim or all claims for a specific date range

My Personal Information

Participant ID

235258

Name

Michelle McKenzie

Date of Birth

12/30/1966

Gender

Female

Marital Status

Married

Home Local

479 My Address

Address Type

Home

Primary

Yes

Address

101 Denver

City

Atlanta

State

GA

Country

United States of America

Postal Code

10016

Address Type

Work

Primary

No

Address

101 Denver

City

Atlanta

State

GA

Country

United States of America

Postal Code

10016

My Contact Information

Phone Number

333-333-3333

Primary Phone

Yes

Web Email Address

michelle******@gmail.com

Primary Email

No

Quick Links

Update Personal Information

All Updates to your personal information will immediately and permanently change your account with the Fund Office.

01

Step 1

02

Step 2

Participant ID

DOB

First Name

Last Name

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Gender

Female

Option 2

Option 3

Option 4

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Marital Status

Vacation

Option 2

Option 3

Option 4

Home Local

Update Personal Information

All Updates to your personal information will immediately and permanently change your account with the Fund Office.

01

Step 1

02

Step 2

Documents on File/Pending Admin Review

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Type	Date	Status
Header Pension Beneficiary Form	Header 03/19/2018	Header In Progress
Header Pension Beneficiary Form	Header 03/19/2018	Header In Progress

Type

Date

Status

Header

Pension Beneficiary Form

Header

03/19/2018

Header

In Progress

Header

Pension Beneficiary Form

Header

03/19/2018

Header

In Progress

My Address

All Updates to your address will immediately and permanently change your account with the Fund Office.

Address 1

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Address Type

Home

Option 2

Option 3

Option 4

Address

City

State

Country

Postal Code

Address 2

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Address Type

Home

Option 2

Option 3

Option 4

Address

City

State

Country

Postal Code

My Contact Information

Enter the information you wish to update in the applicable field. These changes automatically update your account.

Phone Number

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Primary Phone

Yes

Option 2

Option 3

Option 4

Add New Phone Number

Web Email Address

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Primary Email

No

Option 2

Option 3

Option 4

Add New Email Address

Account Settings

If you wish to change your password, email or security question, please do so in the corresponding boxes below.

Missing Contribution Form

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Employer/Production

Member Name or SSN

Work Period

State

Work Location

Postal Code

Address 1

Employer/Production

Member Name or SSN

Work Period

State

Work Location

Postal Code

My IATSE NBF Funds

Health & Welfare

Current Coverage

Plan A Family

Plan C-MRP

Pension

Annuity

Click to access your Principal Account details and payments

Vacation

Health & Welfare

H&W

> Plan C-MRP Family

Plan C-MRP Details

Coverage

Plan C-MRP Family

Coverage Period

10/01/2023 - 12/31/2023

MRP Balance

$2,839.99

Administrative Fee Met

10/19/2021

Enrollment Form Sent

01/01/2023

Lapse

No

Participation Termination

No

Combined Account

No

Forfeitures

No

QMSCOs

No

CAPP Account

Previous Balance:

$8,678.18

October

$175.97

November

$88.00

December

$172.84

Total Contributions

$9,114.99

Admin Fees:

$175.97

Medical Reimbursements:

$88.00

Amount Available:

$172.84

Co-Payment:

$172.84

Premium Payment:

$172.84

Transfers/Waivers:

$172.84

Ending Balance

$8,678.18

Contribution Detail

Statement Activity

Account Actions

Other Coverages

Health & Welfare

H&W

> Plan C-MRP Family

> Coverage History

Coverage History

Health & Welfare

H&W

> Plan A Family

Participant ID

213844

Coverage Status

Plan A Family

Coverage Period

November 2023 - April 2024

Coverage History

Days Worked

April '23'

19