Amendment No. 9
To the Summary Plan Description of the Southern California IBEW-NECA Health Trust Fund Restated As Of September 1, 2017

This Amendment to the Southern California IBEW-NECA Health Trust Fund, Active Health Plan Summary Plan Description ("SPD”) (restated as of September 1, 2017 as amended), is made by the Board of Trustees of the Southern California IBEW-NECA Health Trust Fund ("Board of Trustees”) with reference to the following facts and circumstances:

1. The Board of Trustees wishes to amend the SPD to reflect the termination of the CIGNA DHMO Plan and the implementation of the upgraded DeltaCare USA 40R DHMO Plan effective for all claims incurred on and after January 1, 2022.
2. The Board of Trustees has reserved to themselves the ability to amend the SPD from time to time.

NOW THEREFORE, effective January 1, 2022, the SPD is amended as follows:

1. All references in the SPD appearing at Article 9, Dental Plans Available to You, Article 17, Eight Federal Laws You Should Know About, and Article 18, Disclosure Information, and elsewhere in the SPD are amended by removing "CIGNA DHMO Dental”.
2. Article 2, Plan Benefits Available to You, and all subsections are amended by removing "CIGNA Dental” from the Dental Benefit Options.
3. Article 9 of this SPD, Dental Plans Available To You is amended by removing "CIGNA Dental Plan (DHMO)” from the list of Dental Plans. The second paragraph is amended by replacing the existing language with the following language:
   
   "The Administrative Office offers three (3) dental plans from which to choose: a dental Preferred Provider Organization (PPO) plan and two (2) Dental Health Maintenance Organizations (DHMO) plans. The dental PPO plan is provided by United Concordia. The DHMO plans are DeltaCare USA 40R (also known as Delta Dental), and United Concordia. We suggest that you carefully review all of the Plans and discuss these different Plan options with your family members. A brief overview of the United Concordia PPO Plan and the DHMO plans (DeltaCare USA 40R and United Concordia) appears on the following page. Please refer to your Evidence of Coverage document for a complete description of your dental benefits, including the exclusions and limitations.”
4. Section 9.1 of this SPD, Comparison of Dental Benefits Available to You, is amended by replacing the existing table with the following table:
   

   Dental Provider Name	United Concordia	DeltaCare USA 40R	United Concordia
   Plan Type	PPO	DHMO	DHMO
   Member Customer Service	(800) 332-0366	(800) 422-4234	(866) 357-3304
   Website Address	unitedconcordia .com	deltadentalins .com	unitedconcordia .com
   Claims Filing Address Applies to PPO plan only	P.O. Box 69421, Harrisburg, PA. 17106-9421
   Description	MEMBER CO-PAYMENT
   Network	In-Network/ Out-of-Network	In-Network Only	In-Network Only
   Annual deductible
   Per individual	$0/$25	N/A	N/A
   Per family	$0/$75	N/A	N/A
   Annual Maximum Waived for diagnostic and preventive
   Per individual	$5,000	N/A	N/A
   Per family	N/A	N/A	N/A
   Diagnostic/Preventive X-rays, exams, cleanings	0%/0%, plus balance billing	$0	$0
   Basic Fillings, sealants, oral surgery, root canals	5%/20% plus balance billing	$0 (for white fillings)	$0 (for white fillings)
   Major Crowns and casts, dentures, bridges, and implants	25%/50% plus balance billing Implants only: 25%/25% plus balance billing	$0 (no added metal fees) (Implants not covered)	$0 ($125 metal fee may apply for noble and/or high noble metals on crowns) (Implants not covered)
   Orthodontics Typical cost of completing a 24-month orthodontic treatment plan for permanent teeth for children, up to 19th birthday	50%/50% plus balance billing, up to max payment of $1,400	$950 - $1,400 Startup and retention charges not noted	$1,500 - $2,000, startup and retention charges not noted
   Emergency Services Emergency exam	0%/0% plus balance billing	$0	$0

All other terms and conditions of the Plan shall remain in full force and effect.

BY: Signature on File
Chairman

BY: Signature on File
Secretary