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

      

Letter of Introduction

To All Local 11 Active Employees and Their Eligible Dependents:

This booklet contains a general description of all benefits which eligible active electricians and their eligible dependents are entitled under the Southern California IBEW-NECA Health Plan. You get a choice of one of the following Plans. The benefit plans described in this booklet are as follows:

  • Medical/Hospital Plans (Choice of One)
    • Kaiser Plan (HMO)
    • PacifiCare (HMO)
    • Self-Funded Hospital/Medical Indemnity Plan
      (with Anthem Blue Cross PPO option)
  • Dental Plans (Choice of One)
    • CIGNA Dental Maintenance Organization (DMO) Plan
    • DeltaCare Dental USA Maintenance Organization (DMO) Plan
    • Safeguard Dental Maintenance Organization (DMO) Plan
    • United Concordia Dental Maintenance Organization (DMO) Plan
    • Self-Funded IBEW-NECA Dental Plan
  • Prescription Drug Plan
    • Prescription Solutions Walk-In Pharmacy Plan
    • Prescription Solutions Mail Order Pharmacy Plan
    • Health Fund Reimbursement Plan
  • Vision Care Plans
    • Vision Service Plan ("VSP") [PacifiCare & Indemnity Plan Participants]
    • Kaiser Vision Plan (Except prescription safety glasses for employees only through VSP.)
  • Life Insurance/AD&D Benefits
    • Metropolitan Life
  • Member Assistance Program
    • PacifiCare Behavioral Health

The Health Plan was established for you as a result of collective bargaining agreements between IBEW Local 11 and the National Electrical Contractors' Association. Your Employer has agreed under a provision of the collective bargaining agreements to make contributions to the Fund, which are used to pay for the costs of the benefit plans described above.

The power to administer the Fund and adopt rules and regulations governing the payment of benefits is vested in the Board of Trustees. The payment of any benefit is subject to all terms and conditions of the Southern California IBEW-NECA Health Trust Fund Document; the Agreement and Declaration of Trust establishing the Southern California IBEW-NECA Health Trust Fund; Contracts issued to the Fund by the Kaiser Foundation Health Plan, PacifiCare Health Plan, Anthem Blue Cross of California, CIGNA Dental, DeltaCare Dental USA, United Concordia, Safeguard Dental, Vision Service Plan, Prescription Solutions, Metropolitan Life Insurance Company, and PacifiCare Behavioral Health, as well as any rules and regulations which the Trustees may adopt from time to time.

Benefits under the Southern California IBEW-NECA Active working Electricians' Health Plan are financed through Employer contributions that are specifically designated to provide health benefits for active Employees. There is no vested right to receive Plan benefits. The Trustees may change 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.

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
June 2004