A Guide to Your Family Health Benefits

Summary

To see your Summary of Benefits chart, click here.

Glossary

To see definitions of commonly used terms, click here.

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To All Participants

We are pleased to provide you with this up-to-date booklet describing your health and welfare benefits. This booklet, the Summary Plan Description (SPD) of the Electrical Welfare Trust Fund, the “Plan,” reflects all changes made to the Plan through January, 2013. Read this information carefully and keep it handy for future reference. Note that the terms “Plan” and “Fund” are used throughout this book interchangeably. Both terms refer to the Electrical Welfare Trust Fund.

Your health benefits network is the UnitedHealthcare Choice Plus Network (UHC). UnitedHealthcare owns the previous preferred provider organization (OneNet). UHC offers a wide choice of providers as well as deep discounts on provider services, saving valuable health benefit dollars for both you and your Plan. With the exception of dental coverage, throughout this SPD, when we refer to your “network” we are now referring to UnitedHealthcare. For dental benefits, your PPO network remains with OneNet PPO.

Your Plan continues to offer programs to help keep you and your family healthy. Take advantage of the physical exam benefit, the coverage for well-woman exams and coverage for well-child care. The Employee Assistance Program (EAP) can privately and confidentially help you and your family members cope with the pressures of daily life, both at work and at home.

We trust that these programs will help the Plan continue to provide important protection for you and your family for many years to come, while keeping your out-of-pocket expenses to a minimum. To help control costs for yourself and for the Plan, remember:

  • Visit network Providers for medical, dental, and vision coverage
  • Use toll free numbers or the Internet to find a network Provider near you
  • Do not use the Emergency Room if your medical problem is not an emergency
  • Take advantage of the EAP benefit—you and your family are entitled to up to eight free visits with an EAP counselor

As you know, health benefits is an area where changes are constantly occurring. A number of changes to the terms of the Plan were required by the Patient Protection and Affordable Care Act (the PPACA), adopted as of January 1, 2011.

We will do our very best to keep you informed of other new regulations and Plan changes as they take place. You may always contact the Fund Office either by telephone or on the web (www.ewtf.org) to make sure you have the latest information regarding Plan benefits.

Also note that as the Trustees of the Fund, we have the discretion to determine eligibility for benefits and to interpret the terms of the Plan. Our decision is final and binding on all parties, including participants and their beneficiaries, employers, unions, providers and any other claimant or Business Associate.

Please note that information obtained from social media such as Facebook and Twitter, or from any other sources, is subject to the Plan rules as interpreted by the Board of Trustees. If there is a conflict between the rules of the Plan and other sources, the Plan rules always govern.

If you have questions concerning the Plan, contact the Fund Office at 301-731-1050 or at 1-800-929-3983 or at http://www.ewtf.org. The Fund Office staff are happy to assist you.

Sincerely,

BOARD OF TRUSTEES