Article 17: Disclosure Information >>

17.1 As Required by the Employee Retirement Income Security Act of 1974 (ERISA)

A. Name and type of administration of the trust fund:

The name of the trust fund is the Southern California IBEW-NECA Health Trust Fund.  The Trust Fund is administered by the Board of Trustees of the Southern California IBEW-NECA Health Trust Fund, a collectively bargained, jointly-trusteed labor-management Trust Fund.

B. Name and address of the person designated as agent for the service of legal process:

Joanne M. Keller, CEO/Administrator
Thomas Schaefer, Assistant Administrator
100 Corson Street, Suite 200
Pasadena, CA 91103
(Service of legal process may also be made upon any Trustee)

C. Administrative Office of the Plan Administrator:

100 Corson Street, Suite 200
Pasadena, CA 91103
Administrator: Joanne M. Keller
Assistant Administrator: Thomas Schaefer

D. Names, titles, and addresses of the Trustees:

E. Source of financing of the Plan and identity of any of the organizations through which benefits are provided:

Payments are made to the Plan by individual Employers under the provision of the applicable Collective Bargaining Agreements.

The Trustees provide a choice of hospital/medical/prescription drug programs.

The following organizations provide benefits by virtue of contracts with the Board of Trustees as follows:

• Anthem Blue Cross of California – PPO Hospital/Medical/Prescription Drug Benefits
• Kaiser Permanente Foundation Inc. – HMO Hospital/Medical/Prescription Drug Benefits
• UnitedHealthcare of California – HMO Hospital/Medical//Prescription Drug Benefits
• Delta Dental (DeltaCare USA) – DHMO Dental Benefits
• United Concordia – PPO AND DHMO Dental Benefits
• Vision Service Plan – Vision Benefits
• Anthem Blue Cross Life and Health Insurance Company – Life Insurance/AD&D benefits
• Optum, the health services division of UnitedHealth Group – Member Assistance Program (MAP)
• MedExpert – Advocacy and Assistance Services
• Body Scan International (BSI) – Medical Body Scans

F. Date of the end of the Plan year

June 30

G. Internal Revenue Service Plan Identification Number

95-6140101

H. A description of the relevant provisions of any applicable collective bargaining agreement:

The Plan is maintained pursuant to Collective Bargaining Agreements between Local #11 of the International Brotherhood of Electrical Workers, AFL-CIO and the L.A. County Chapter of the National Electrical Contractors Association. Copies of Collective Bargaining Agreements may be obtained by Plan participants from the Union or Administrative Office without charge upon written request. Additionally, Collective Bargaining Agreements may be examined by Plan participants at the Administrative Office of the Plan during regular business hours.