Descriptions of Service
Description of Service
Local 49 Self Funded
Healh Insurance Plan
Local 49 Health & Welfare Fund Self-Insured Plan
- As a self-insured plan all benefits are paid using member and employer contributions
- Participating employers
contribute on all hours worked
- Eligibility requires 360
hours per quarter for coverage. Once 360 hours have been worked, there is
a one-month waiting period with coverage beginning the first day of the
following month
- Any hours over and above
those needed for coverage (360 hours) per quarter are held in a reserve hour bank, up
to a maximum of 720 hours or two quarters of coverage
- Retiree Plan that provides
eligible participants subsidized coverage based on years of service
Active Employees
Medical Benefits
- Self Insured Plan
- Access to Blue Cross Nationwide
Network
- $250 Individual Deductible
per year,
$500 Family Deductible per year - $1,000,000 Lifetime maximum
- $25 medical office visit
co-pay
- Pays 100% on lab work and
x-rays
- Preventative benefit is
$350 per calendar year
- Health Dynamic Physicals coverage at 100%
- Chiropratic -100% up to $40
per day or $750 per year
- Maximum out-of-pocket
medical expenses per covered person is $2500 per calendar year
(after all deductible has been satisfied) - Maximum out-of-pocket
medical expenses for family is $6000 per calendar year
(after all deductible has been satisfied) - Co-payments after
deductibles have been satisfied for hospital charges are now:
80% for Participating Provider charges and
75% for Non-Participating Provider charges for all covered persons - Effective January 1, 2008 -
prescriptions coverage, 20% Co-Pay and an annual out of pocket limit of
$2500 for prescriptions
Vision
- $200 per person per year.
- $500 lifetime maximum per
eye for Lasik surgery
- Cleaning equipment is not
covered
Dental
- 80% of covered charges up
to a maximum of $1,500 per person per calendar year
- Orthodontia: $1,000 maximum lifetime benefit for minor dependents
- Orthodontia: $2,000 maximum payment per accident
Life Insurance
- $8,000 for active members
- $8,000 AD & D for
active members
Disability
- $200 weekly benefit, up to
a maximum of 26 weeks, for active bargaining members
For your specific benefit coverage questions, please call
Wilson-McShane at 1-800-535-6373