10.4 ERISA-Required Information

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

1. Name and type of administration of the Plan:
   The name of the Plan is the Southern California IBEW-NECA Health Trust Fund. The Plan is administered by a Board of Trustees, jointly-trusteed labor-management Trust Fund.
2. 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)
3. Administrative Office of the Plan Administrator:
   100 Corson Street, Suite 200
   Pasadena, CA 91103
   Administrator: Joanne Keller
   Assistant Administrator: Thomas Schaefer
4. Names, titles, and addresses of the Board of Trustees:
   

   Labor Trustees (IBEW Local #11)

   Management Trustees (LA NECA)

   Joel Barton, Secretary c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Eric Brown c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Gaylord Roten    c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Tommy Faavae, Alternate c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Marc Greenfield, Alternate c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103

   James M. Willson, Chairman c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Jeff Davis c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Sean McKenna c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 Eric Cartier, Alternate c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103 David Nott, Alternate c/o Administrative Office 100 Corson Street, Suite 200 Pasadena, CA 91103

5. Source of financing of the Plan and identity of any of the organizations through which benefits are provided:
   
   Payments are made to the Trust Fund by individual Employers under the provision of the applicable Collective Bargaining Agreements and self-payments are required for participation in the Retiree Health Plan.
   
   The Board of Trustees provides a choice of hospital/medical programs.
   
   The following organizations provide benefits by virtue of contracts with the Board of Trustees as follows:
   This section modified by: Amendment 5. View Previous Language.
   • Kaiser Foundation Health Plan, Inc. — HMO hospital/medical benefits
   • UnitedHealthcare of California — HMO hospital/medical benefits
   • Citizens Rx — Self-funded prescription drug benefits
   • CIGNA — DHMO dental benefits
   • Delta Dental (DeltaCare USA) — DHMO dental benefits
   • United Concordia — PPO AND DHMO dental benefits
   • Vision Service Plan — Vision benefits
   • MedExpert — Advocacy and assistance services
   • Coast Benefits - HRA benefits

   x
   • Kaiser Foundation Health Plan, Inc. — HMO hospital/medical benefits
   • UnitedHealthcare of California — HMO hospital/medical benefits
   • CIGNA — DHMO dental benefits
   • Delta Dental (DeltaCare USA) — DHMO dental benefits
   • United Concordia — PPO AND DHMO dental benefits
   • Vision Service Plan — Vision benefits
   • MedExpert — Advocacy and assistance services
   • Coast Benefits - HRA benefits
6. Date of the end of the Plan Year
   June 30
7. Internal Revenue Service Plan Identification Number
   95-6140101
8. 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 Los Angeles County Chapter of the National Electrical Contractors Association (NECA). Copies of Collective Bargaining Agreements may be obtained, upon written request, by Participants from the International Brotherhood of Electrical Workers (IBEW), AFL-CIO, Local 11 or the Administrative Office without charge. Additionally, Collective Bargaining Agreements may be examined by Participants at the Administrative Office during regular business hours.