Health and Welfare

Summary Plan Description 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

Information About the Plan

Name of Plan

The Electrical Workers General Welfare Fund, usually referred to as the IBEW Local 701 Welfare Fund.

Plan Sponsorship and Administration

A Board of Trustees is responsible for the operation of this Plan. The Board of Trustees consists of an equal number of Employer and Union representatives, selected by the employers and the Union which have entered into collective bargaining agreements which relate to this Plan. If you wish to contact the Board of Trustees, you may do so by calling or writing the Fund Office.

The Trustees are assisted in the day-to-day administration of the Plan by a salaried Fund Administrator. The Trustees are also assisted by Fund Legal Counsel, a Fund Consultant and a Fund Auditor who have contracts to provide the professional services the Fund.

Source of Financing/Plan Participation

All contributions to the Plan are made by employers in accordance with their collective bargaining agreements or participation agreements with the International Brotherhood of Electrical Workers, Local No. 701. The Fund Office will provide you, upon written request, information as to whether a particular employer is contributing to this Plan on behalf of participants working under the collective bargaining agreements. Employees are entitled to participate in this Plan if they work under one of the collective bargaining agreements or participation agreements and if their employers make the required contributions to the Fund on their behalf. Administrative employees of IBEW Local 701 and its affiliates, including this Fund, are also entitled to participate in the Plan. The Fund also receives self-payments from employees, retirees and dependents for the purpose of continuing coverage under the Plan. The Fund may also receive rebates from its pharmacy benefits manager.

Type of Plan/Accumulation of Assets/Payment of Benefits

Benefits are provided from the Fund’s assets which are accumulated under the provisions of the collective bargaining agreement and the Trust Agreement and held in a trust fund for the purpose of providing benefits to covered participants and defraying reasonable administrative expenses. The Fund’s assets and reserves are invested appropriately. The Fund’s custodial bank is BMO Harris.

The Fund provides medical, prescription drug, surgical, hospital, disability, dental/orthodontia, vision and hearing benefits on a self-insured basis. When benefits are self-insured, the benefits are paid directly from the Fund to the claimant or beneficiary. The self-insured benefits payable by the Fund are limited to the Fund assets available for such purposes. Although, as described earlier in this Summary Plan Description, Blue Cross reprices PPO claims involving medical, surgical and hospital benefits, and National Vision Administrators processes claims involving vision benefits, the services of these companies are in the nature of claim processing and/or limited to the amount the Fund must pay providers, and all benefits paid remain self-insured.

This Plan is not an insurance policy and no benefits other than the Life and Accidental Death and Dismemberment (AD&D) Insurance benefits, and the Medicare Part D plan for retirees are provided through insurance companies. The Fund provides Life and AD&D Insurance through the Union Labor Life Insurance Company, 1625 Eye St. N.W., Washington, D.C., 20006, telephone 1-202-682-0900. The Fund’s Medicare Part D plan is insured through the UnitedHealthCare Insurance Company, 185 Asylum St., Hartford, CT 06103, telephone 1860-702-5000.

The Fund Counsel to the Board of Trustees is the Plan’s agent for service of legal process. Accordingly, if legal disputes involving the Plan arise, any legal documents should be served upon Fund Counsel at the address shown on page 92.

Plan Year

The records of the Plan are kept separately for each plan year. The plan year begins June 1 and ends on May 31.

Identification Numbers

The number assigned to this Plan by the Board of Trustees pursuant to instructions of the Internal Revenue Service is 501. The number assigned to the Board of Trustees by the Internal Revenue Service is 36-2951116.