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IBEW Local 11-LA NECA Retiree Health Plan
Summary Plan Description (SPD)

      

Letter of Introduction

To All IBEW-NECA Participants of the Southern California Retiree Health Plan:

We are pleased to provide you with this new Summary Plan Description booklet which summarizes the health benefits available to eligible Local 11 retirees and their eligible spouses.   The Southern California IBEW-NECA Retiree Health Plan offers only Health Maintenance Organization (HMO) medical Plans to retirees and their spouses.  Retirees (and spouses, if married) enrolled in Medicare Parts A and B may select the Medicare Supplement Plan instead of an HMO.  There is a voluntary Premium Reimbursement Benefit for retirees who live outside the service area of any of the HMO Plans.

The Retiree benefits include:

  1. A choice of HMO Plans, a Medicare Supplement Plan, or Premium Reimbursement Plan.
  2. Prescription drug benefits.
  3. Dental benefits for Social Security Disability retirees under 65 only.  The Medicare Choice plans (HMO plans) for over age 65 Medicare retirees provide dental benefits through the HMO.
  4. Vision benefits for Social Security Disability retirees under 65 only.  The Medicare Choice plans (HMO plans) for over age 65 Medicare retirees may provide certain vision benefits through the HMO.
  5. Death benefit.
Benefits under the Southern California IBEW-NECA Retiree Health Plan are partially financed through Employer contributions that are specifically designated to provide health benefits for retired Employees. There is no vested right to receive Plan benefits. The Trustees may change, modify, reduce or terminate the Plan benefits at any time as a result of conditions or events requiring such action.

The Trustees, as a matter of fiduciary responsibility, may periodically review Plan benefit assumptions based on such factors as total hours worked and projected costs and make any required benefit enhancements, eliminations, or modifications as a result of changing conditions or events.

Any verbal or written representations made by any Employer, Union, or Health Fund Administrative Office employees or representatives will not be binding on the Board of Trustees.

The Board of Trustees' procedures for changing, enhancing, reducing, or eliminating benefits are enumerated in the table of contents titled "Plan Amendment Procedures".

To assist you in obtaining Plan benefits, the Trustees have established an Administrative Office. However, any final decision concerning an individual's qualification for benefits under this Plan is made exclusively by the Board of Trustees. Again, any representations, either oral or written, made by employees of the Health Fund Administrative Office, or by Employer or Union employees or representatives, will not be binding upon the Board of Trustees.

The HMOs provide each enrolled participant with detailed information on their plans that are offered through the Southern California IBEW-NECA Retiree Health Plan.  This literature provides specific information on benefits provided, benefit exclusions, preventative services provided, and the amount of cost sharing (called co-payments) which you must pay.  This benefit information will also explain where you must receive medical services to be covered for benefits.

This booklet was prepared for your assistance. Take time to read it and become familiar with its contents. If you have any questions concerning your benefits or need assistance, please call or write the Administrative Office. The address, phone number, and office hours are shown under the heading "General Information."

Sincerely,


The Board of Trustees
Southern California IBEW-NECA Health Trust Fund
October 1, 2006