Retirement Services Group Appointments

1

Reason For Your Appointment* This field is required.

Retirement Planning: This appointment is only for purposes of planning for your retirement and that you are not actually retiring. This appointment will review the information outlined on your pension statement and explain the various optional forms of payment as of an estimated future retirement date. Be sure to bring your pension statement with you to your in-person scheduled appointment.

Pension Application: This appointment is only for members that are retiring and have received a pension application packet to complete. The pension application packet contains several forms that you must complete. Please complete as much of the pension application packet that you are able to prior to your appointment, keep the forms in numerical order and bring the pension application packet with you to your in-person schedule appointment.

Worker Retention Program (WRP): This appointment will help members better understand the requirements and calculation of the Worker Retention Program benefit. To provide a custom estimate, a current SSA statement will need to be provided at the time of appointment. Please note that the WRP benefit is an ancillary benefit which may be terminated at the discretion of the Trustees should the need for the program no longer exist with any earned benefits payable upon retirement.

Other (General inquiries, turn in a form, death benefits)

2

Have you received a pension statement from the Retirement Services Group within the last 6 months?

YESNO

3

Have you received a pension application packet within the last 6 months?

YESNO

4

Can you please provide more details about the nature of your visit? * This field is required.For example: I would like to drop off a completed form or I have some general retirement questions that I would like to ask.

5

Member's Name* This field is required.

First Name

Last Name

6

MOE ID Number* This field is required.This is NOT your Local 150 registration ID number.

Your MOE ID Number is located on your medical ID card or your MOE Vendor card

7

Member's Primary Phone Number* This field is required.

Please enter a valid phone number.

8

Member's Email* This field is required.

example@example.com

9

Are you or any of your covered dependents currently on Medicare? * This field is required.This includes early Medicare due to disability or End-Stage Renal Disease (ESRD).

YESNO

10

Who is completing this appointment registration on your behalf?* This field is required.

Self

Spouse

Other (son/daughter/POA/relative)

Fund Office Staff Member

11

Have you attended a Pre-Retirement Seminar in the last two years?* This field is required.

YESNO

12

Please select your appointment type:* This field is required.

I will be there in person for this appointment

I would like a phone appointment

13

When do you prefer to have your appointment?

During the week (Monday through Friday)

On a Saturday

14

Weekday Appointments- Central Standard Time* This field is required.Due to the increased volume of phone calls and appointments during Open Enrollment, appointments are limited to 1 hour.

15

Saturday Appointments- Central Standard Time* This field is required.

16

What is your estimated date of retirement?* This field is required.Please note that your retirement date has to be the first of the month following your last hours worked. For example: If your last hours worked are 06/17/2022, you would need to enter 07/01/2022 as your estimated date of retirement.

Date

17

Do you need a translator for your appointment?* This field is required.

NO

YES, I SPEAK SPANISH

18

Are you or your companion disabled and need access to an elevator? * This field is required.

YESNO

19

I acknowledge that this appointment is to be held at the Midwest Operating Engineers Fringe Benefit Funds office at 6150 Joliet Rd. Countryside, Il. 60525. If I am unable to attend my appointment, I understand that I must contact the Retirement Services Group at 708-579-6630 at least 24 hours in advance to re-schedule or cancel.* This field is required.

Yes, I acknowledge the appointment information described above