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

Medicare Part D Prescription Drug Plan (PDP) for Retirees

The prescription drug benefits for participants with primary coverage through Medicare – this applies to all retirees and their dependents – are provided through the Plan-sponsored UnitedHealthCare Medicare prescription drug plan (PDP), an insured group Part D plan, with a supplemental plan provided through Sav-Rx. Because of the supplemental benefit (called a “wraparound” benefit), participant co-pays can be kept low, with no donut hole or additional deductible.

How it Works

The two plans work together behind the scenes to coordinate benefits with no additional enrollment requirements or claim filing on the participant’s part. All PDP plan participants have to do is use two prescription ID cards instead of one.

UnitedHealthCare and Sav-Rx will provide you with information concerning your co-pays, covered and noncovered drugs, and instructions for using the mail-order and specialty pharmacies. (Although the PDP program has been developed to mirror the Plan’s active prescription drug program, it is governed by federal rules, so certain differences are unavoidable.) UnitedHealthCare and Sav-Rx will handle customer service, prior authorizations and appeals.

UnitedHealthCare will be your primary prescription drug plan, and Sav-Rx will provide supplemental coverage.

When a retiree or a dependent of retiree becomes eligible for Medicare, they MUST start using the Part D (EGWP) plan. Call the Fund Office immediately if you need the applicable I.D. cards, and be sure to give your two new cards to your pharmacist.

Enrollment Is Automatic

You will automatically be enrolled in the new program when Medicare becomes your primary plan. Except for using your two new I.D. cards, you do not need to take action in order to continue accessing your prescription drug benefits.

You have the option to NOT participate in the PDP. However, if you decline to participate, you will not have any prescription coverage through the IBEW Local 701 Fund. In that case, your self-payment for this Fund’s retiree coverage will NOT be reduced, and you will need to obtain creditable drug coverage elsewhere. If you do not enroll in creditable coverage without a gap in coverage, you may be subject to a late enrollment penalty. To disenroll, call the Fund Office at 1-630-393-1701, prompt #3.