Health & Welfare Fund Summary Plan Description

About this Booklet
   Amendment and Interpretation of the Plan
   Upon Becoming a Participant

Your Health and Welfare Benefits
   ... At a Glance
   Schedule of Benefits
   Eligibility
   Initial Eligibility by Hours
   Initial Eligibility by Self Contributions
   Qualifying Schedule
   Coverage Effective Date
   Continuation of Eligibility
   Coverage Termination Date
   Coverage for Your Dependents
   Medical Child Support Orders
   Coordination of Benefits
   Reinstatement of Coverage
   Self-Contribution Provisions
      For Active Participants
      For Non-Medicare Retirees
      For Retirees Eligible for Medicare
   COBRA

Comprehensive Major Medical Benefit
   Your Benefits
   The Deductible
   Common Accident
   Maximum Benefits
   Automatic Reinstatement
   Maximum Benefit Reinstatement
   Hospital Pre-Admission Certification
   Hospital Pre-Admission Certification Penalty
   Eligible Medical Expenses
      Abortions
      Ambulance Service
      Chiropractic Care
      Dental Benefit
      Dental Work or Treatment
      Diabetic Services and Supplies
      Durable Medical Equipment
      Emergency Care
      Eye Care or Treatment
      Facility Fees
      Home Health Care
      Hospice Care
      Hospital
      Laboratory Benefit
      Maternity Care
      Mental Nervous
      Office Visits
      Orthotics
      Physical Therapy
      Pre-Admission Testing
      Premature Birth and Congenital Malformation
      Preventive Care
      Prosthetics
      Skilled Nursing Facility
      Speech Therapy
      Surgery
      Urgent Care
      Weekly Disability Benefits
   Ineligible Medical Expenses
   Pre-Existing Conditions Limitations
   Subrogation
   Fund's Right of Recovery

Prescription Drugs and Medicines Benefit
   Covered Prescription Expenses
   Deductible and Co-Payment Amounts
   Limitations

Claims Procedures
   Definition of a Claim
   Assignment
   Submitting Claims
   Timely Filing Limit
   Payment of Claim
   Not in Lieu of Workers' Compensation
   Plan Change or Termination

Benefit Appeal Procedures
   Initial Claim Determination
   Definitions
   Time Limits
   Concurrent Care Decisions
   Claim Denial Procedures
   Claim Review Procedures
   Filing an Appeal
   Decision on Review

Life Insurance Benefit
   Beneficiary
   Conversion Privilege
   Accidental Death and Dismemberment Benefit
   Who Will Receive Benefits
   Definitions
   The Benefits
   Beneficiary
   Losses that are Not Covered
   Dependents' Life Insurance Benefit
   Effective Date of Dependents' Life Insurance
   Termination of Dependents' Life Insurance
   Conversion Privilege
   General Provisions
   How to Appeal a Life Insurance Claim
   Facility of Payment
   Examinations
   Legal Actions
   Change of Beneficiary
   Conformity with State Laws

Medicare and Your Plan Coverage
   When will you become entitled to Medicare Benefits
   Life Insurance Conversion Privilege
   Eligibility Requirements for the Medicare Supplemental Plan
   Payment of Claim
   How Your Claim is Processed
   Your Prescription Drug Coverage and Medicare

Key Terms and Definitions

Notice of Privacy Practices

Rights and Protections Under ERISA

Important Information Required by ERISA