Eligibility

Overview

Retirees with 10 full Eligibility Credits based on Hours of Work or Qualified Military Service who have worked at least 300 hours in covered employment in each of the 2 years prior to Retirement and have worked at least 400 hours in covered employment in 3 of the last 5 years prior to Retirement may be eligible to enroll in Retiree Health and Welfare benefits.

Summary Plan Description (Retirees)

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Dependents

Overview

If you elect coverage for yourself, you are also eligible for medical, dental and vision coverage for your eligible Dependents on the later of the day you become eligible for your own coverage or the day you acquire an eligible Dependent, either by marriage, birth, adoption or placement for adoption, but only if you have submitted a completed written enrollment form that may be obtained from the Trust Fund Office and provided the Plan’s required proof of Dependent status is received by the Trust Fund Office.

A Dependent may not be enrolled for coverage unless the Participant is also enrolled. Specific documentation to substantiate Dependent status will be required by the Plan. An eligible Dependent includes your lawful spouse or Qualified Domestic Partner, and your Dependent children.

See below for more information on Qualified Domestic Partners and Dependent Children.

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Medical

Overview

Qualified Retirees have the option to enroll in the Indemnity PPO Plan or Kaiser (provided the Retiree lives within the Kaiser service area).  Both options include medical, prescription and vision benefits.  Retirees must pay a share of the cost of coverage which is typically done by a deduction from your Pension benefit. Additionally, any Retiree is permitted to enroll in one of two dental options provided through Delta Dental.  Premiums for dental coverage will be deducted from your Pension benefit.

Summary Plan Description (Retirees)

Plan Comparison for Medicare Retiree Benefits

Plan Comparison for Non-Medicare Retiree Benefits

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Dental

Overview

Dental benefits are available through a voluntary Retiree dental program insured by Delta Dental. The dental plan requires a separate enrollment, payment of premiums covering the full cost of the coverage and has separate eligibility and termination rules. You can enroll in medical benefits without enrolling in the dental plan.

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Vision Benefits

Overview

The benefits described below are available to Participants and eligible Dependents of the Indemnity Medical Plan.

You pay the Copayment regardless of whether you use a VSP Member Doctor or a non-VSP provider. The $10 exam Copayment is due only once each year, for the first service you receive each year (unless you qualify for the low vision benefit, which has additional Copayments).

To find a VSP provider, call VSP at (800) 877-7195 or visit www.vsp.com.

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Prescription Drugs

Overview

The Prescription Drug Plan is managed by the Fund’s Pharmacy Benefit Manager (PBM). The PBM uses a variety of tools to provide safe access to approved prescription drugs. In addition to an approved list of drugs, known as a formulary, the PBM employs other edits which may include, but not be limited to: Prior Authorization for certain therapies, step therapy edits that require the use of tried and proven prescription drugs prior to the approval of newer more costly drugs, frequency and dosing limits, retail refill allowance that channels participants into the mail order delivery method, and Genetic and/or Efficacy testing. Prescriptions submitted that do not comply with PBM rules will be denied. Additionally, the PBM actively monitors for fraud, waste, and abuse which does occur, and intervenes to case manage such events.

The Plan provides a retail pharmacy program and a mail order option for your prescription drug needs. When you need a medication for a short time – an antibiotic, for example – it is best to choose the retail pharmacy program. If you are taking a medication on a long-term basis, it is usually less costly and more convenient to have it filled through the mail order program.

Summary Plan Description (Retirees)

Express Scripts

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Self-Pay Rates

Overview

Retirees are responsible for a self-payment for a portion of the cost of their health benefits and responsible for the full premium for dental benefits. The Health and Welfare self-payment and dental premiums will be typically be deducted from the Retiree's Pension benefit amount. If the Pension benefit is not sufficient to cover the amount of the Health and Welfare self-payment, Retirees are required to make a monthly check payment to continue coverage. If Pension benefits are not sufficient to cover the amount of the dental premiums, enrollment in the dental plan is impermissible.

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