Benefit Summaries
These summaries are consise versions of the highlights of major plan features and rules. They are meant for easy reference, particularly on a mobile device, and are not intended to be authoritative.
The Summary Plan Description (SPD) contains the full description of the Plan rules and benefits. When in doubt, consult the SPD.
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Eligibility for Class 1 & Class 13 Participants
Initial Eligibility
You will become eligible for benefits on the first day of the month following the month in which you meet one of the credited-hour requirements below (based on contributions paid to the Fund).
Class 1 and Class 13 employees are bargained-for employees for whom employers make contributions for each hour worked.
Class 1 and Class 13 employees who are eligible for benefits because they have satisfied the eligibility rules described below normally will be covered under the Plan A Schedule of Benefits. When you are eligible for Plan A benefits, your dependents will also be eligible for Plan A benefits.
Eligibility for Class 1 & Class 13 Employees and Newly Eligible Class 1 & Class 13 Employees (contributions are paid for credited hours):
- 300 hours of contributions, or
- 600 hours in six consecutive months, or
- 1,000 hours in nine consecutive months, or
- 1,200 hours in twelve consecutive months.
If you are disabled on your effective date, your coverage begins when you return to active work (following the same “first day of the month after” timing based on your return).
Dependent Eligibility
Your dependents will be eligible for benefits as long as you are eligible. New dependents will be eligible automatically, but you must complete the required forms and supply the required documentation. Spouses who work will be treated as having their employer’s plan as primary and this plan as secondary, even if they opt out of their employer’s plan, unless qualifying for a hardship exemption.
Staying Eligible
After you meet the initial requirements you must meet either requirement.
- 300 credited hours in the paired contribution quarter, or
- 1,200 credited hours in the 12-month lookback window for that coverage quarter.
Quarter mapping (with the 12-month lookback):
Coverage Quarter Contribution Quarter Lookback Jan–Mar Aug–Oct Nov 1 – Oct 31 Apr–Jun Nov–Jan Feb 1 – Jan 31 Jul–Sep Feb–Apr May 1 – Apr 30 Oct–Dec May–Jul Aug 1 – Jul 31 Note: There’s a two-month administrative lag between the contribution quarter and its related coverage quarter.
Losing Coverage
You cease to be covered when you work insufficient credited hours to earn continuing coverage described above, failure to make timely short-hours payments, or when you enter military service.
See the summary of the various forms of continuation coverage available that might allow you to stay eligible after losing coverage for insufficient hours.
Reinstatement
If you lose eligibility for benefits because you work insufficient credited hours, you once again must become eligible as a new participant.
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Classes Other than Class 1
If you are not eligible via credited hours as a Class 1 participant, you can be covered under one of these other classes.
Class 3 — Non-Bargained-For
Generally, this class is for employees of contributing employers who are not working under the bargaining agreement.
- Eligibility is based on monthly employer contributions.
- Initial coverage begins on the first day of the first full month of employment for which a contribution is made.
- Coverage continues as long as monthly contributions are made.
- Short-hours self-payments, eligibility during disability, and retiree coverage do NOT apply. COBRA coverage is available.
Class 6 — Owners in Fact
Generally, this class is for employee of owners in fact who are working under the bargaining agreement.
- Eligibility is hours-based like Class 1, but adjusted to 437.5 hours/quarter; no 12-month lookback.
- Short-hours self-pay allowed (uses the Class 1 rules, adjusted to 437.5 hrs).
- COBRA, disability, and retiree provisions apply.
Class 7 — Staff
This class is for employees of the union local and the benefit administration office who are not working under the bargaining agreement.
- Initial coverage begins on the first day of the month following the first full month of employment for which a contribution is made.
- Coverage continues as long as monthly contributions are made.
- No short-hours or disability extensions; COBRA is available.
Class 11 — Factory Sign
Class 11 (factory sign) employees are governed by a collective bargaining agreement which require monthly employer contributions of a specified amount.
- Initial coverage begins on the first day of the month for which a monthly contribution is made.
- Coverage continues as long as monthly contributions are made.
- No short-hours/disability/retiree coverage; COBRA available.
Class 14
Eligibility is based on employer contributions.
- Initial coverage begins on the first day of employment for which a contribution is made.
- Coverage continues as long as contributions are made.
- Short-hours self-payments do NOT apply.
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Continuation Coverage (All Forms)
This page summarizes ways to keep coverage when eligibility would otherwise end. Tap a heading to read the full SPD language.
COBRA Continuation Coverage
What it is: A federal right to keep Plan coverage for a limited time after certain “qualifying events.” Eligible individuals (you and/or dependents) may elect COBRA and pay the required premiums on time.
When it applies: Events like a loss of eligibility due to insufficient hours, termination/reduction of hours, or specified family status changes.
The Plan will provide election information after a qualifying event.
How it ends: At the end of your applicable maximum COBRA period (if premiums are paid on time) or earlier if a COBRA termination event occurs (see SPD “Termination of COBRA Coverage”).
Short-Hours Self-Payment
What it is: If you fall short of the required hours needed for a coverage quarter, you may keep coverage by making a correct and timely self-payment for the related contribution quarter.
Duration: You may make full self-payments for up to four successive quarters. Coverage tied to short-hours self-payments terminates at the end of the last coverage quarter corresponding to the contribution quarter you made a self-payment for.
Timing matters: Payments must be made in the manner and by the deadlines stated in the SPD/Trustee notices.
Temporary Disability (Extended Eligibility)
What it is: When you are temporarily disabled, the Plan may credit “disability hours.” If your disability hours plus any employer-contributed hours meet the requirement for the contribution quarter, coverage continues into the linked coverage quarter.
Proof & end: You must satisfy the Plan’s documentation rules. Coverage continues only while the contribution-quarter requirement is met.
Permanent & Total Disability (Extended Eligibility)
What it is: Special extended-eligibility rules apply if you meet the Plan’s definition of permanent and total disability. Coverage may continue while the SPD criteria are met.
Coordination: Requirements, proof, and duration are as set out in the SPD. Coverage ends under the conditions listed there (including failure to meet eligibility criteria for the applicable quarters).
Family & Medical Leave (FMLA)
What it is: During approved FMLA leave, coverage can be maintained as required by law and the SPD. You may be required to pay your share of contributions/premiums.
Reinstatement: Coverage status upon return follows FMLA and Plan rules (see SPD for details and required steps).
Military Service (USERRA)
What it is: If you enter qualified military service, you may be entitled to continue Plan coverage by making self-payments as provided under USERRA and the SPD.
When it ends: If you don’t elect/pay for continuation, eligibility otherwise ends on the date you enter the armed forces. Rights to continue/reinstate coverage depend on timely notice and your length/type of service (see SPD).
At-a-glance
- Missed hours? Try Short-Hours Self-Pay (up to four successive quarters) or, after a qualifying event, COBRA.
- Disabled? See Temporary or Permanent & Total disability rules for extended eligibility.
- On leave? See FMLA. Military service? See USERRA.
Coverage/Contribution timing: coverage quarters end Mar 31, Jun 30, Sep 30, Dec 31. There is a two-month administrative lag between a contribution quarter and its related coverage quarter. See the SPD for exact rules.
This summary is informational; the SPD governs in all cases.
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Dental
Dental Benefit
This benefit helps pay for covered dental services for you and your eligible dependents. The Plan pays a percentage of covered dental charges, up to the calendar year maximum shown in your Schedule of Benefits. The annual maximum does not apply to preventive and routine services paid at 100% for dependent children under age 19.
Delta Dental Of Illinois
The Fund has an agreement with Delta Dental Of Illinois, a dental preferred provider (PPO) network administrator and an affiliate of Blue Cross Blue Shield of Illinois. Delta Dental Of Illinois offers a large network of participating dentists who have agreed to charge negotiated fees that are generally lower than their usual charges.
This is a voluntary program—you are not required to use a Delta Dental Of Illinois dentist, and your benefits won’t be reduced if you use a non-participating dentist. However, you will usually save money by using Delta Dental Of Illinois dentists because the negotiated fees reduce your out-of-pocket costs.
How Dental Benefits Are Determined
When you (or a covered dependent) have expenses for covered dental charges, the Plan pays the following percentages of covered charges, subject to Plan rules and the calendar year maximum shown in your Schedule of Benefits.
Benefit Schedule (Percentages)
Type of Service Plan Pays Preventive and Routine 100% Minor Restorative 80% Major Restorative 50% Orthodontia (if included on your Schedule of Benefits) 50% up to the orthodontia maximum
Covered Dental Services
Preventive and Routine (Plan pays 100%)
Covered Service Frequency / Notes Prophylaxis (cleaning) Twice per calendar year Oral examination and diagnosis Twice per calendar year X-rays (if necessary) Full mouth x-rays once every three calendar years Topical fluoride applications (dependent children under age 19) Once per calendar year Sealants (dependent children under age 19) Covered (frequency not stated here; subject to Plan rules) Periodontal prophylaxis Up to four per calendar year (counts toward the two regular cleanings allowed per year) Minor Restorative (Plan pays 80%)
- Emergency treatment for relief of pain
- Restorative services (amalgam, synthetic, porcelain, plastic fillings)
- Endodontics (pulpal therapy, root canal filling)
- Oral surgery (including extractions)
- Note: surgical removal of partially or completely bony impacted teeth is covered under the Major Medical Benefit; tissue-only impactions are covered under the Dental Benefit
- Periodontics (treatment for disease of gums)
Major Restorative (Plan pays 50%)
- Gold restorations when teeth cannot be restored with another filling material
- Crowns, inlays, onlays, and jackets when teeth cannot be restored with a filling material
- Prosthetics (bridges, partial dentures, complete dentures)
- Implants
- Replacement prosthetics (crowns, bridges, dentures, implants) are covered if dentally necessary, provided the original prosthetic is at least five years (60 months) old
Orthodontia (if included in your Schedule of Benefits)
If your Schedule of Benefits includes orthodontia coverage, the Plan pays 50% of necessary treatment up to the orthodontia maximum shown on your Schedule.
Orthodontia benefits are payable only for dependent children, and only if treatment begins while the child is under age 19.
Date Of Service (for payment purposes)
For payment purposes, treatment is considered incurred on the date the service is rendered. However, for the following services that require more than one visit, the incurral date is considered to be:
- Full or partial dentures: when the impression is taken
- Root canal therapy: when the tooth is opened
- Fixed bridgework, crowns, and other gold restorations: when the tooth is first prepared
Dental Benefit Exclusions
Covered dental charges do not include charges for:
- Any treatment or service not prescribed by a dentist or oral surgeon
- Cosmetic services and supplies, including bleaching/whitening of teeth, or personalization/characterization of dentures
- Services, supplies, or appliances provided in connection with the jaw, any jaw implant, or the temporo-mandibular joint (TMJ)
- Periodontal splinting
- Replacement of a removable prosthetic due to loss or damage
- Adjunctive tests for oral cancer screening (for example, Vizilite)
- Any treatment or service excluded under the Plan’s General Plan Exclusions and Limitations
Contact Information
Delta Dental Of Illinois
Phone: 800-323-1743
Website: www.deltadentalil.com -
Prescription (Rx)
Prescription Drug Program
This benefit helps pay for covered prescription drugs when filled under the Plan’s drug program. The Prescription Drug Program is administered by Sav-Rx, a pharmacy benefit manager.
Retirees eligible for Medicare receive drug coverage through a separate, Plan-sponsored Medicare Part D prescription drug plan. The summary below applies to non-Medicare retirees and active participants under the main drug program.
How the Program Works
- Participating pharmacies: Use a participating Sav-Rx pharmacy to receive negotiated pricing and have your copays apply directly.
- 30-day retail fills: For short-term or acute prescriptions, present your Sav-Rx card at a participating pharmacy and pay the applicable copay.
- Maintenance / long-term fills: Maintenance prescriptions (for ongoing conditions such as high blood pressure, diabetes, heart disease, etc.) can be filled up to a 90-day supply through the mail-order program or through participating retail pharmacies designated for 90-day fills.
- Initial maintenance fill rule: For a new long-term or maintenance medication, your first two short-term (30-day) fills must be at a participating retail pharmacy before the 90-day mail-order/retail option applies.
Your copay amounts vary by:
- whether the drug is generic, preferred brand, non-preferred brand, or specialty;
- whether the drug is filled at a 30-day retail pharmacy, 90-day retail pharmacy, or mail order;
- and the Schedule of Benefits applicable to your benefit plan.
Out-of-Pocket Limits
For Plans other than Plans 11 and 11-C, the prescription drug copay amounts count toward the medical Plan’s in-network out-of-pocket limit. Once that in-network limit is met in a calendar year, covered prescription drug copays are $0 for the remainder of the year.
Plans 11 and 11-C have separate drug out-of-pocket limits, as shown on the applicable Schedule of Benefits.
Your Copays
Your copay amounts or percentages are shown in the Schedule of Benefits for your benefit plan. Copays vary depending on:
- whether the drug is a generic, preferred brand, or non-preferred brand,
- where the drug is purchased (retail vs mail order),
- and the quantity supplied.
Clinical Management Programs
The Prescription Drug Program includes clinical rules that affect coverage:
Mandatory Generic Substitution
If a covered generic equivalent is available and you decline it, you must pay the applicable brand copay plus the difference in cost between the non-preferred brand and the generic (unless a letter of medical necessity is provided).
Mandatory Mail-Order for Maintenance Medications
After two short-term fills of a maintenance medication, you must use the mail-order program or a designated 90-day retail pharmacy for the fourth and all subsequent fills.
Specialty Drugs
Specialty medications typically require prior authorization and are usually limited to a 30-day supply and may need to be filled through Sav-Rx’s specialty pharmacy.
Prior Authorization / Step Therapy
Certain medications may require review and prior authorization before coverage, or may be subject to step therapy protocols.
Over-the-Counter Prescription Drugs
Some products normally available over the counter (like certain antihistamines or proton pump inhibitors) are covered at the generic copay only if prescribers provide a written prescription and any required prior authorization.
Covered Drugs
Covered drugs include medications that require a physician’s written prescription to be dispensed by a licensed pharmacist. The Plan also covers:
- insulin and diabetic supplies under the Prescription Drug Program,
- certain over-the-counter products when prescribed and covered under the program.
Exclusions and Limitations
The following are not covered under the Prescription Drug Program, regardless of whether a prescription is written:
- Over-the-counter (non-prescription) drugs, except as specifically permitted above.
- Experimental, investigative, or inappropriate drugs.
- Drugs to treat infertility or obesity (these may be covered under the Major Medical Benefit).
- Drugs for treatment of sexual dysfunction (except certain drugs under limited prior authorization conditions).
- Drugs filled outside of a participating network pharmacy without coordination of benefits.
- Drug supplies to replace lost or stolen medications, or refills obtained before allowed refill intervals.
- Any drug excluded under the Plan’s general exclusions and limitations.
The separate Medicare Part D plan has its own exclusions and limitations.
Contact Information
Sav-Rx (Prescription Drugs)
Phone: 866-233-4239
Website: savrx.com -
Vision
Vision
This benefit helps pay for routine vision examinations and for glasses or contact lenses, subject to Plan rules. The Plan offers two options: a preferred provider program through National Vision Administrators (NVA), and an indemnity (scheduled out-of-network) option. Because of discounts available through NVA, you will usually receive a better value by using an NVA provider. Union Eyes is part of the Union Wellness Center, and you and your family can receive a FREE exam and one free pair of glasses per year. You can use any one of the 8 Union Eyes Centers throughout the Chicagoland area. Contact Union Eyes for an appointment by either calling 312-888-9999 or online at www.unioneyes.com.
Important note: Vision benefits are not provided under Plan B (the low-option self-pay plan).
Benefit Schedule — NVA Provider
Covered Service Frequency Plan Pays Eye Exam once per calendar year Provided in full Eyeglass Lenses (plastic lenses) one pair per calendar year Provided in full Frames one every two calendar years $50 wholesale allowance Contact Lenses (in lieu of eyeglasses) per calendar year $100 allowance Safety Glasses (active participants only) one per calendar year $100 allowance
Benefit Schedule — Non-NVA Provider
Covered Service Frequency Plan Pays (you pay any remainder) Eye Exam once per calendar year up to $50 Lenses — Single Vision one pair per calendar year up to $65 Lenses — Bifocal or Trifocal one pair per calendar year up to $75 Frames one every two calendar years up to $125 Contact Lenses (in lieu of eyeglasses) per calendar year up to $100 Safety Glasses (active participants only) one per calendar year up to $100
Notes and Limitations
- Contact lenses are covered in lieu of eyeglasses, not in addition to them.
- Sunglasses are not covered unless prescribed to be worn substantially at all times.
- Anti-reflective coatings and vision training are not covered.
- Medical or surgical treatment of the eye is not covered under this benefit.
- Routine vision exams required by an employer are not covered.
- General Plan exclusions and limitations apply.
If you order glasses or lenses while covered, the benefit may continue after coverage ends as long as the order is picked up within 30 days after coverage terminates.
Contact Information
National Vision Administrators (NVA)
Phone: 800-672-7723
Website: www.e-nva.com -
Special Fund Program
Special Fund Program
The Special Fund Program covers a wide range of healthcare expenses not payable by the regular health care Plan. Special Fund accounts can also be used to make active and retiree self-payments when you lose eligibility or retire.
The Special Fund Program is administered by a third-party administrator in accordance with the terms of a contract with the Fund. The administrator will provide eligible participants with additional information about how to use the program, and a debit card that can be used to cover your co-pays at medical facilities, offices and drug stores.
Your Special Fund Account
When you work for an employer that participates in the Special Fund program, a separate contribution will be made on your behalf and credited to your individual Special Fund account.
You determine how and when to use your account. You can choose to use it to pay for qualified expenses or other services not covered by the regular Plan, or to make self-payments to continue coverage.
The amount in your Special Fund account rolls over from year to year and will remain available to you until you need it, subject to the forfeiture rule described below.
Qualified Expenses
Qualified expenses are medical costs allowed under IRS rules (Section 213(d)) and may include:
- Medical expenses such as deductibles and coinsurance
- Prescription drug copays
- Dental services (including deductibles, coinsurance, and non-covered services)
- Home modifications/equipment for a disabled person
- Infertility treatment
- Vision expenses
- Hearing care expenses
- Active and retiree self-payments to this Plan
- Premiums for other healthcare plans
- Medicare Part B premiums and Medigap policies
- Electronic body scans
- OTC drugs with doctor’s prescription
- Weight loss programs
- Certain transportation expenses for specialized treatment
Qualified expenses must:
- Be incurred on or after January 1, 2017;
- Not be reimbursable by this Plan or any other plan;
- Be incurred by you or a dependent who was covered under the regular Plan at the time; and
- Not be claimed as a deduction on your federal tax return.
For a full list of IRS qualified expenses, refer to IRS Publication 502.
Excluded Expenses
Your Special Fund account cannot be used for:
- Expenses incurred before January 1, 2017
- Expenses for persons not eligible for regular Plan benefits
- Expenses not considered deductible medical expenses by the IRS
- Items such as air purifiers, burial expenses, clothing, cosmetic surgery, childcare costs, household help, personal trainers, vitamins/minerals, etc.
- Expenses incurred when you (or the dependent) were not covered under the regular medical plan
Using Your Special Fund
Debit Card
- You can use your Special Fund debit card to pay for qualified expenses directly at the provider’s office.
- If you receive a balance due statement from a doctor or hospital, you can write the debit card number on the statement to pay with your Special Fund.
- You must wait until the Plan has processed the claim before using your Special Fund account to pay the unpaid balance.
Online or Paper Claims
- You may upload claims through the Special Fund administrator’s online system.
- You may also submit paper claims to the Special Fund administrator using claim forms available on the administrator’s website.
- Reimbursements not paid via the card are made by check payable to you.
- Benefits cannot be assigned directly to a provider.
Self-Payments
- You may use your Special Fund account for self-payments to this Plan (e.g., active or retiree coverage or COBRA premiums).
- Contact the Fund Office for instructions on authorizing these payments from your account.
Claim Filing Deadline
- Claims must be received by the end of the calendar year following the year in which the expense was incurred.
Account Tracking and Extras
- You can track your Special Fund account balance and activity securely through the Special Fund administrator’s website.
- Additional debit cards for family members are free; contact the administrator if you need one.
Retirement, Death, and Forfeiture Rules
- Your Special Fund account balance is not forfeited when you retire, provided you remain eligible as a retiree.
- In the event of your death or disability, the balance may be used by your surviving spouse or eligible dependents for qualified expenses and self-payments, as long as they remain eligible.
- An account may be forfeited due to inactivity if it remains below $100 with no activity for 24 months, or if it has no activity for 48 months and has a balance of $100 or more.
- Special Fund accounts are not vested; they remain general assets of the IBEW Local 701 Welfare Fund and may be amended or discontinued by the Trustees.
Opt-Out Option
Federal law requires that participants be given the option to opt out of the program. If you choose to opt out, you forfeit your account balance permanently, and future employer contributions revert to the Fund’s general assets. Contact the Fund Office for details.
Contact Information
Third-Party Special Fund Administrator
Phone: 1-877-282-8665
Website: www.tasconline.com -
Members Assistance Program (MAP)
➡️ Looking for support right now? Visit the Members Assistance Program (MAP):
https://ibew701.multiemployer.com/map
Members Assistance Program (MAP)
The Members Assistance Program (MAP) is a confidential support resource available to you and your family at no cost. MAP is designed to help with everyday challenges, unexpected crises, and longer-term concerns that can affect your work, health, or family life.
MAP services are completely confidential, voluntary, and available whether or not you are currently using other Plan benefits.
How MAP Can Help
MAP provides support and referrals for a wide range of concerns, including:
- Stress, anxiety, and emotional well-being
- Family and relationship concerns
- Substance use and recovery support
- Financial and legal guidance
- Grief, loss, and life transitions
- Workplace challenges
- Crisis intervention and short-term counseling
You do not need a referral, diagnosis, or prior approval to use MAP.
Confidential and Easy to Use
- Available to members and eligible family members
- No cost to you
- Private and confidential
- Available when you need it—not just during a crisis
Learn More and Get Help
This page provides only a brief overview.
For full details on MAP services, how to access support, and what to expect:➡️ Visit the Members Assistance Program (MAP):
https://ibew701.multiemployer.com/map
Sometimes the best step is simply knowing where to turn. MAP is there when you need it.