Disclosure 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 Retiree Health Plan.  The Plan 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.



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

   George Wallace, Administrator
   6023 Garfield Avenue
   Commerce, CA 90040
   (Service of legal process may also be made upon any Trustee)
   
   




3. Administrative Office of the Plan Administrator:

   6023 Garfield Avenue
   Commerce, CA 90040
   Administrator:
   George Wallace

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



Labor Trustees (IBEW Local #11)

Management Trustees (NECA)

Marvin Kropke, Secretary c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040 Eric Brown, Alternate c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040 Marshall Goldblatt c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040 Mark Meyer, Alternate c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040 Dean Todd c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040

James M. Willson, Chairman c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040 Henry Turner c/o Administrative Office 6023 Garfield Avenue Commerce, CA 90040



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

   Contributions are made to the Trust by individual Employers under the provision of applicable Collective Bargaining Agreements.  In addition, retirees and/or covered spouses must pay for coverage in order to obtain certain benefits under the Plan.  A supplemental source of financing is interest earned on investments and realized gains from the sale of assets.
   
   The Trustees provide a choice of hospital/medical programs.  
   
   The following organizations provide benefits or adjudicate claims by virtue of a contract with the Board of Trustees as follows:
   
   Kaiser Permanente Foundation Health Plan, Inc.
   Hospital/Medical – Benefits provided under a Kaiser contract
   
   PacifiCare of California
   Hospital/Medical – Benefits provided under a PacifiCare contract
   
   Prescription Solutions
   Self-Funded Prescription Drug Benefits
   
   Self-Funded Dental Plan
   Claims paid by Allied Administrators, Inc.
   
   CIGNA
   Dental – Benefits provided under a CIGNA contract
   
   DeltaCare USA
   Dental – Benefits provided under a Delta Dental contract
   
   United Concordia
   Dental – Benefits provided under a United Concordia contract
   
   Safeguard Dental
   Dental – Benefits provided under a Safeguard contract
   
   Vision Service Plan
   Vision Benefits
   
   Integrated Member Assistance Program
   Benefits provided under a PacifiCare Behavioral Health contract



6. Date of the end of the Plan year:
June 30


7. Internal Revenue Service Plan Identification Number:
No. 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 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 Trust Fund during regular business hours.


9. Remedies available under the Plan for the redress of claims, which are denied in whole or in part, including provisions required by Section 503 of Employee Retirement Income Security Act of 1974 are fully described in the Claims and Appeal Rules section.