• SPD Table of Contents
  1. Important Contact Information
  2. Introduction
  3. Table of Contents
  4. Plan A Schedule of Benefits
  5. Plan B Schedule of Benefits
  6. Plan C Schedule of Benefits
  7. Plan 11 Schedule of Benefits
  8. Plan 11-C Schedule of Benefits
  9. Eligibility for Active Participants
  10. Eligibility for Retiree Coverage
  11. Insurance Coverage
  12. Weekly Loss of Time Benefit
  13. Medical Benefits
  14. Prescription Drug Program
  15. Medicare Part D Prescription Drug Plan (PDP) for Retirees
  16. Members Assistance Program (MAP)
  17. Dental Benefit
  18. Vision Benefit
  19. Hearing Benefit
  20. Special Fund Program
  21. General Plan Exclusions and Limitations
  22. Other Limitations on Your Benefits
  23. Definitions
  24. Claim and Appeal Procedures
  25. General Plan Provisions
  26. Information About the Plan
  27. Board of Trustees

Eligibility for Retiree Coverage

QUALIFYING FOR THE RETIREE PLAN

You must meet the following requirements in order to qualify for post-retirement benefits from the IBEW Local 701 Welfare Fund:

1. You must be receiving an Early, Regular or Disability Pension from the Electrical Workers General Pension Fund (the “Local 701 Pension Fund”);
2. You must have been eligible for benefits from this Plan for a minimum of ten years; and
3. You must have been eligible for benefits from this Plan for at least three years out of the last five years immediately preceding your retirement.

PAYING FOR RETIREE PLAN BENEFITS

Although retiree coverage is subsidized by the Welfare Fund, you are required to help pay for your coverage. The amount a person must pay is based on the following components:

1. The HCP benefit from the Local 701 Pension Fund. If you are receiving an HCP benefit, you must sign over the benefit to receive coverage.

PLUS

2. A base amount under the 45,000-hour rule. Your monthly cost under the 45,000-hour rule is based on the number of lifetime hours contributed for you. If you have 45,000 or more lifetime hours, your payment under this rule is $0. If you have fewer than 45,000 hours, your monthly cost is determined as follows: Base Amount x [1 - (Number of lifetime hours worked / 45,000)]

The base amount in the above formula is currently $300 per retiree, and $600 for a retiree and dependent spouse.

PLUS

3. A supplemental age rate based on your current age:

Supplemental Age Rates (Subject to Change)

Supplemental Age Rates (Subject to Change)

• The age 55-64 rates apply to all participants who retired on or after January 1, 2002. The 65 and over rates apply to all retirees.
• Your rates will change as you age. Rate changes are effective on the first day of the month in which your birthday occurs.
• If your spouse is covered by another employer-sponsored plan, then you do not have to make the self-payment listed in this table for your spouse. (Note: employed spouses are subject to the Working Spouse Rule – see page 24.)

PLUS

4. $160 per month to cover each child. You can cover any of your children who meet the Plan’s definition of a dependent child, provided you elect coverage for them when you first elect retiree coverage. You must maintain continuous coverage for your child(ren). If coverage is dropped, it cannot be reinstated. A child’s coverage will terminate when the child no longer meets the Plan’s definition of a dependent, for example, on the first day of the month after the child’s 26^th birthday.

Summary - Each Month a Retiree Pays:

HCP

+ Base amount (45,000-hour rule)

+ Supplemental age rate (see table above)

+ $160 per child

All self-payment amounts and rates will be reviewed annually and increased as necessary to keep pace with the cost of providing the coverage.

Examples

1. Dan retires at age 65 with over 45,000 lifetime hours. Dan will turn over his HCP benefit to the Fund, and because he has more than 45,000 hours, he will not have to pay any portion of the base amount. However, because Dan has a 63-year old spouse, he will be required to pay $40 per month for his retiree benefits (see chart above).
2. Henry retires at age 55 with 30,000 lifetime hours. He has a spouse but no dependent children. In addition to signing over his HCP, Henry will be required to pay:

Base amount (45,000 hour rule):

$600 x [1 - (30,000/45,000)] = $200

Supplemental age rate:

Retiree age 55 and spouse = $400

Henry’s TOTAL monthly self-payment = $600

Applying for Retiree Coverage

You must apply to the Fund Office no later than 30 days after the date of your retirement. You will become covered as a retiree on the later of the first day of the month following your retirement or the first day of the month after your application for retiree coverage has been filed.

Self-Payment Due Date

Retiree self-payments are due by the first day of the coverage month. Your payment will be deducted from your monthly pension check to insure that your coverage will not be terminated due to a late or forgotten payment.

BENEFITS PROVIDED TO RETIREES

Benefits for retirees are the same medical, dental, vision and hearing benefits as Plan A, the benefit schedule covering most active participants. A $2,500 retiree Life Insurance benefit is included. Weekly Loss of Time Benefits are not provided.

With respect to prescription drug benefits:

• Pre-Medicare - Before a retiree or the dependent of a retiree becomes eligible for Medicare, his or her prescription drug benefits will be the same as benefits provided under Plan A for active participants.
• Post-Medicare - Once a retiree or the dependent of a retiree becomes eligible for Medicare, his or her prescription drug benefits will be provided through the Fund’s insured Medicare Part D prescription drug plan. See “Medicare Part D Prescription Drug Plan (PDP) for Retirees” on page 55 for more information.

DEPENDENT ELIGIBILITY FOR RETIREE PLAN BENEFITS

You can include your spouse and children in your retiree coverage if they meet the Plan’s definition of a dependent and you make the required self-payments for their coverage.

If you marry after you become eligible for retiree coverage, you may add and self-pay for your new spouse effective the first day of the third calendar month after the date of your marriage, provided you notify the Fund Office of your remarriage within 90 days of the marriage. If the first day of the third month is more than 90 days after your marriage, your new spouse’s effective date will be the first day of the second calendar month following your marriage.

You may NOT add your new stepchildren to your retiree coverage.

In the Event of Your Death

If your surviving spouse is covered under the Plan when your death occurs, your spouse may continue to self-pay for retiree coverage for your spouse and any eligible surviving children until your spouse remarries.

TERMINATION OF RETIREE COVERAGE

Your eligibility for retiree coverage will end on the first to occur of the following events:

1. On the day you reestablish eligibility as an active participant;
2. Six months after you return to active employment; or
3. On the last day of the last month that the Fund Office received your correct and timely self-payment.

Your dependent’s retiree coverage will end on the first to occur of the following events:

1. On the day your coverage ends;
2. On the last day of the month that he or she no longer meets the definition of a “dependent” described on page 74;
3. On the last day of the last month for which he or she fails to make a correct and timely self-payment to the Fund Office;
4. On the last day of the month in which your death occurs, unless your surviving spouse is eligible to continue making self-payments for continued retiree coverage;

Your surviving spouse and/or child may postpone or suspend this Plan’s retiree coverage if he or she is eligible to enroll in another group health plan. In such case, that person’s retiree coverage may be reinstated when the other group coverage ends, provided the Fund Office is notified within 30 days after the termination date. There cannot be a break between the coverages;

5. If your surviving spouse is making self-payments to continue retiree coverage after your death, on the last day of the month that he or she remarries; or
6. On the last day of the month in which your child, including your surviving child whose coverage is being continued after your death, fails to meet the definition of a dependent, or, if earlier, when your surviving spouse’s coverage terminates (for example, if she remarries).

COBRA Coverage for Divorced and Surviving Spouses and Terminated Dependent Children

If a divorce or legal separation from your spouse occurs while your spouse is eligible for retiree coverage, or in the event of your death, he or she is entitled to elect COBRA coverage for a maximum coverage period of up to 36 months after the date coverage would otherwise terminate due to the divorce or legal separation. The same applies to a child who loses coverage because he or she no longer meets the Plan’s definition of a dependent (at age 26 for example).

The dependent’s maximum COBRA period starts with the date of the divorce, loss of dependent status or your death, whichever is applicable. Any coverage granted under the Plan’s regular provisions for survivors of retirees will offset the person’s 36-month COBRA period. A surviving spouse whose retiree coverage terminates early due to remarriage can continue coverage under COBRA if the remarriage occurs before he or she has had 36 months of regular survivor coverage.

COBRA coverage provides the same class of benefits that the person was eligible for when the COBRA qualifying event occurred. Eligibility for Medicare or another group plan does not affect a person’s initial entitlement to elect COBRA. However, if the eligibility for that coverage occurs after COBRA coverage starts, then COBRA coverage will terminate.

It is the responsibility of the affected dependent spouse to notify the Fund Office of the date of the divorce, legal separation, birthday, death or remarriage within 60 days of the event, or within 60 days after Plan coverage would otherwise terminate, whichever date is later. Failure to provide notification within the time limits will result in the denial of COBRA coverage.

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