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


PLAN AMENDMENT NO. 16
TO THE
SOUTHERN CALIFORNIA IBEW-NECA ACTIVE HEALTH PLAN

  1. The sub-heading entitled "Employees" on Page 20 of the Active Health Plan under the "COBRA" Section is amended as follows:
  2. If you have established eligibility under the Plan, you have the right to choose this continuation coverage if you lose eligibility under this Plan for any reason other than your engaging in Non-Covered Electrical Employment. The date your coverage is lost is the date on which your right to elect COBRA coverage commences. The lost of coverage is treated as the "qualifying event" by the plan. However, an employee will not be eligible for COBRA coverage if the employee's loss of coverage under this Plan is as a result of work in Non-Covered Electrical Employment.

  3. The subheading "Spouses" on page 21 of the Active Plan under the Section entitled "COBRA" is amended by replacing the existing language with the following:

    If you are the legal spouse of an employee covered for health care benefits under this Plan, you have the right to choose continuation coverage for yourself if you lose health coverage under this Plan for any of the following reasons:

    1. Loss of coverage, including a loss of coverage due to termination of your spouse's employment or reduction in your spouse's hours of employment;
    2. Covered employee's death;
    3. Loss of dependent status under the Plan;
    4. Divorce or legal separation from your spouse;
    5. Your spouse becomes eligible for Medicare;
    6. Or

    7. Your spouse's employer files for Chapter 11 reorganization.

      However, a legal spouse of an employee will not be eligible for COBRA coverage if the employee's loss of coverage under this Plan is a result of the employee's work in Non-Covered Electrical Employment.

  4. The sub-heading entitled "Children" on Page 21 of the Active Health Plan under the "COBRA" Section is amended as follows:

    If you are a dependent child, as defined under the Section on the Plan entitled "Eligible Dependents", of an employee covered under this Plan, you have the right to choose continuation coverage for yourself if you lose health coverage under this Plan for any of the following reasons:

    1. Loss of coverage by the employee, including loss of coverage due to termination of the employee parent's employment or reduction in the employee's hours of employment;
    2. The divorce or legal separation of the employee parent and his or her legal spouse;
    3. Covered employee parent's death;
    4. 4. The employee parent becomes eligible for Medicare;
    5. The dependent ceases to be a dependent child under the Plan rules, for example, due to a dependent reaching an age which is no longer considered an eligible dependent under the Plan; or

    6. The employee parent's employer files for Chapter 11 reorganization.

      In no event will an Eligible Dependent be entitled to continuation coverage if the employee parent's loss of coverage under this Plan is as a result of the employee working in Non-Covered Electrical Employment.

  5. A new sub-heading entitled "Domestic Partners" is added to Page 21 of the Active Health Plan under the COBRA" Section as follows:

    Eligible Domestic Partners as that term is defined under this Plan are not entitled to elect COBRA continuation coverage unless they are enrolled under one of the insured HMO Plans. If an eligible Domestic Partner is enrolled under one of the insured HMO Plans, the Domestic Partner will be entitled to choose continuation coverage under CAL-COBRA for himself or herself upon a loss of coverage under this Plan for a period of up to 36 months for any of the following reasons:

    1. Loss of coverage by the employee, for reasons including a reduction in the number of hours of employment under the Plan; or
    2. The employee's voluntary or involuntary termination of employment with a contributing employer as defined in the "Definitions" section of this booklet;
    3. Death of the covered employee;
    4. The covered employee becomes eligible for Medicare;
    5. The covered employee's employer files for Chapter 11 reorganization.

      In no event will a Domestic Partner become eligible for CAL-COBRA continuation coverage if the employee's loss of coverage under this Plan is as a result of his/her working in Non-Covered Electrical Employment.

      In no event will termination of a Domestic Partnership constitute a qualifying event entitling the Domestic Partner to CAL-COBRA continuation coverage.

    6. The following new Sub-Section is added to page 24 following the Sub-Section entitled "Dependent/Spouse Change or Address Change":

Section 10. Family Medical Leave Act

The Family Medical Leave Act enacted by Congress in 1993 provides that in certain situations certain employers are required to grant leave to employees and that in such situations the employer is required to continue medical coverage for the employees. The federal legislation specifically provides that more liberal provisions of state law are permitted and also provides that more liberal provisions contained within collective bargaining agreements are permitted.

It is not the role of the Trustees or Trust Fund to determine whether or not an individual employee is entitled to leave with continuing medical care under the federal statute, any state statute or the provisions of a collective bargaining agreement. Disputes as to the entitlement to leave with continuing medical benefits must be resolved by the employer, employee and where applicable, the local union.

To the extent that participants are entitled to leave with continuing medical coverage pursuant to the federal act, state legislation or provisions contained within a collective bargaining agreement, the Trust Fund will provide continuing medical coverage so long as required monthly contributions are received from the contributing employer. Rights under this section in no fashion affect rights under COBRA or rights to continuing medical care pursuant to the disability extension features contained within the Plan.

Approved and adopted by the Board of Trustees of the Southern California IBEW-NECA Health Trust Fund at the Board Meeting held on January 24, 2006 at Commerce, California.

BOARD OF TRUSTEES SOUTHERN CALIFORNIA IBEW-NECA HEALTH TRUST FUND

BY: Signature on File
Chairman

BY: Signature on File
Secretary