• 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

Special Fund Program

The Special Fund program is a health reimbursement account (HRA). It 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 HRA program administrator in accordance with the terms of a contract with the Fund. The HRA 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 costs incurred for medical care as defined under Section 213(d) of the Internal Revenue Code. Qualified expenses include, but are not limited to:

• Medical expenses, including deductibles and coinsurance
• Prescription drug co-pays
• Dental services, including deductibles, coinsurance, and non-covered services
• Home modifications and equipment to accommodate 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
• Medigap policies
• Electronic body scans
• OTC drugs (doctor’s prescription required)
• Weight loss programs
• Residential homes for care of an intellectually or developmentally disabled dependent
• Certain transportation expenses to receive specialized treatment

For a complete list of qualified Special Fund expenses, refer to IRS Publication 502 for the tax year in question.

In addition, medical expenses are only covered under this program if the expenses are:

1. Incurred on or after January 1, 2017;
2. Not reimbursable by this Plan, another health plan, or any other party;
3. Incurred for you or a dependent while the person is covered under the Plan, and in the case of a dependent, incurred while you can claim the person as a dependent under federal income tax rules; and
4. Not claimed as deductions on your or a dependent’s federal income tax return.

Every time you are reimbursed from your Special Fund for a qualified expense, the amount of the reimbursement will be deducted from your account balance.

Examples of Excluded Expenses

Your Special Fund account can NOT be used for any charges that are incurred either prior to January 1, 2017, by a person who is not eligible for regular Plan benefits, or that are not considered by the IRS to be deductible medical expenses. Items which the IRS does not consider deductible medical expenses include but are not limited to the following:

How to Use Your Special Fund

Paperless Options - The HRA administrator offers several paperless claim-submission options. You can use your debit card or upload claims through their website. Information about these options will be sent to participants who are eligible for this program.

If you receive a balance due statement from a doctor or hospital and want to use your Special Fund account to pay for it, you can write your debit card account number on the statement just like you would if you were paying with a credit or debit card. Note that you must wait until this Plan has processed the claim before you can pay the unpaid balance from your Special Fund account.

Some purchases will require documentation to substantiate that the expense is covered under this program. The HRA administrator will contact participants through the online participant portal if additional documentation is required.

Paper Claims - You can also submit paper claims to the HRA administrator. Claim forms are available on their website.

Self-Payments to this Fund - You can also use your Special Fund account to make self-payments for active or retiree coverage, or to pay COBRA premiums to this Fund. Contact the Fund Office for information on how to authorize these types of payment(s) from your account.

Reimbursements - Unless you use your debit card to pay a provider directly, reimbursement checks will be issued by the HRA administrator and made payable to you, the participant. Benefits cannot be assigned to a provider.

Claim Filing Time Limit - Special Fund reimbursement requests can be submitted to the HRA administrator at any time; however, such requests must be received no later than the end of the calendar year following the calendar year in which the expense was incurred.

More Information About the Special Fund Program

Tracking Your Account Balance - You can track your account activity online securely through the HRA administrator’s website: www.tasconline.com.

Additional Cards - Additional cards for your other family members are free. Call the HRA administrator or go to their website if you need another debit card.

When You Retire - Your Special Fund account balance is not forfeited when you retire, provided you remain eligible for benefits under this Plan as a retiree.

In the Event of Your Death or Disability - Death or disability benefits cannot be paid from your Special Fund. However, in the event of your death, the balance in your account can be used by your surviving spouse or eligible dependents to make self-payments to continue their coverage, and for their qualified expenses as long as they remain covered under the Plan.

Forfeiture for Inactivity - Your Special Fund account can only be forfeited due to inactivity. An account will be considered inactive if it has a balance of less than $100 and no account activity for the prior two years (24 months). An account with a balance of $100 or more will be forfeited after four years (48 months) with no activity. “No account activity” means no employer contributions into the account and no withdrawals out of the account for qualified expenses.

Special Fund Accounts Are Not Vested - The Special Fund program is not a pension plan or bank account. You are not vested in the balance. Because this is a health and welfare benefit, all amounts in individual accounts remain general assets of the IBEW Local 701 Welfare Fund. The Trustees reserve the right to eliminate or modify this program at any time and in their sole discretion.

Opt-Out Option - Federal law requires that participants have the option to opt out of this program. If you want to opt out and forfeit your account balance, you can do so at any time. Opting out is permanent, and any future employer contributions made on your behalf will revert to general Fund assets. Contact the Fund Office if you need more information about opting out.

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