Benefit Trust

Speak with a doctor 24/7 from the comfort of your home using a video-enabled smartphone, tablet, or computer. Teladoc’s physicians are board-certified and can diagnose, recommend treatment, and write short-term prescriptions when medically necessary.*

Teladoc offers an affordable and convenient alternative to urgent care or the emergency room. Plus, if you or a loved one are looking for mental health support, you can access a licensed therapist. All calls are confidential.

Teladoc cannot prescribe controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of service.

24 Hour Nurse Line Flyer

Please contact the Benefit Trust Office at 937-454-1744 to determine whether you are currently eligible or covered under the Prescription Drug Insurance plan.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights and much more.

Prescription Drug Insurance is for Active and Retired members and their eligible dependents. Your Pharmacy Benefit Manager is CVS Caremark.

If you have questions regarding your prescription drug benefits, call CVS Caremark at 1-888-202-1654.

Specialty Medications:

All Specialty Medications must be filled by PrudentRx. If you take a specialty medication, you must enroll by calling PrudentRx at 800-578-4403 Monday through Friday from 8:00 a.m. to 8:00 p.m. ET.

Please contact the Benefit Trust Office at 937-454-1744 if you have questions regarding your HRA.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, contributions to your HRA, allowable expenses, and much more. The minimum required claim reimbursement amount is $25 unless your HRA balance is less than that, in which case your claim must be for the entire remaining balance.

Claims and Reimbursement Procedures:

You can use your HRA to reimburse yourself for eligible health care expenses. Claims must be filed within twelve months from the date the expenses were incurred.

To file a claim, please complete and return the HRA Claim Form along with all required documentation necessary to process the claim. Any claim that is denied in whole or in part due to a lack of sufficient funds in the HRA must be refiled to receive reimbursement in the future. Claims will not be automatically reprocessed once funds become available.

Authorizing Payment of Premiums:

You can use your HRA to make premium self-payments if you do not elect COBRA when your eligibility as an Active Participant ends, and after the balances in your hour bank and/or money bank are exhausted. Similarly, you can use your HRA to make Retiree premium payments if you do not elect COBRA when you retire. If you do not have enough HRA dollars remaining, you must pay the remainder of your self-payment or retiree premium payment directly to the Benefit Trust Office. To pay premiums out of your HRA, please complete and return the HRA Premium Payment Claim Form.

On June 1, 2019, the network for your dental benefits is changing. Delta Dental of Ohio will be the new dental network for the Plan going forward. All dental services performed on and after June 1, 2019, will be processed by Delta Dental of Ohio (Delta Dental). The Benefit Trust Office will not process claims for dental services performed after May 31, 2019.

Delta Dental offers two networks—the Delta Dental Preferred Provider Organization (Delta Dental PPO) and Delta Dental Premier networks. Together, these two networks offer you one of the largest networks of dentists and dental specialists in the country. Although your benefit will remain the same in the Premier Network, when you use a provider in the Delta Dental PPO Network, the discounts are greater.

If you have eligible dental care expenses incurred before June 1, 2019, be sure that you (or your provider) submit these claims to the Benefit Trust Office.

If you have dental services performed on or after June 1, 2019, you (or your provider) should submit these claims to Delta Dental. Your claims should be submitted electronically, or mailed to:

Delta Dental of Ohio
Claims Processing
P. O. Box 9085
Farmington Hills, MI 48333-9085

Never let the lack of a current ID card prevent or delay you from getting the care you need. Note: You may also get a temporary ID card online at www.deltadentaloh.com or through Delta Dental’s mobile app on or after June 1, 2019.

You can find participating dentists by visiting Delta Dental’s website (www.deltadentaloh.com), downloading Delta Dental’s free app to your mobile device, or calling Delta Dental’s Customer Service department at 800-524-0149 from 8:30 a.m. to 8:00 p.m. Eastern Time.

Looking for Information About Dental Claims, Eligibility or Benefits?

After June 1, 2019, you can review your eligibility status, claims paid information, and covered benefits by checking out the Delta Dental Consumer Toolkit^® at www.deltadentaloh.com. This toolkit will also enable you to print your own ID cards and can provide you with oral health tips.

Register Online

Your dental coverage through Delta Dental will begin automatically on June 1, 2019 if you are eligible with hours worked for this benefit. We encourage you to register at www.deltadentaloh.com. You’ll create a secure account and have access to provider lists, get help with making dental care decisions, and get access to other programs and resources for dental health.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights, and much more.

Effective January 1, 2021, VSP is your new vision plan provider.

VSP Choice Plan

You can find participating vision providers by visiting VSP’s website or by calling VSP:

www.vsp.com/choicewithaffiliates

800-877-7195

Customer Service Hours of Operation (Eastern Time):

Monday through Friday from 8:00 a.m. to 11:00 p.m.

Saturday and Sunday from 10:00 a.m. to 11:00 p.m.

Your VSP Group Number is 30100827

Vision Plan Highlights

*Enhanced Feature Frame: When using VSP providers in the “Premier Program”

**Progressive Lens copays vary based upon the lens manufacturer and retail cost.

Looking for Information About Vision Claims, Eligibility or Benefits?

You can review your eligibility status, claims paid information, and covered benefits by visiting www.vsp.com or by using the VSP app, and logging into your personalized account. Once logged in, you’ll see personalized benefit information, including doctor visits, benefits history, how to use your benefits, and how to find a provider.

All vision services including your eye exam and vision materials provided on and after January 1, 2021, will be processed by VSP. The Benefit Trust Office will not process claims for vision services provided after December 31, 2020.

Resources for Living makes it easy for you to access resources to help you live your best life. This free
benefit is available to you and all members of your household*. Services are confidential and available
24 hours a day, 7 days a week.

Below are some of the areas where the program can assist.

Emotional well-being support

Access up to three counseling sessions per issue each year. You can also call 24 hours a day for in-the moment emotional well-being support. Counseling sessions are available face to face, on televideo, or chat/text through Talkspace. Start here if you or a family member is coping with mental health issues, addiction issues, anxiety, behavioral health, relationship issues, depression, stress, work/life balance, and more. To continue care after your free visits have been exhausted, you may continue care with your counselor by providing your Aetna ID card and utilizing your Aetna health insurance plan benefits. 99% of our Member Assistance Program providers are also in the Aetna Medical network.

Daily life assistance

Competing day-to-day needs can make it tough to know where to start. Call when you need help finding
resources for childcare, parenting, adoption, elder care, school and financial aid research, pet care,
home repair and improvement, and more.

Legal services

Get a free 30-minute consultation with a participating attorney for up to three new legal topics,
such as civil/criminal law, divorce, mediation, wills and other document preparation, and real estate
transactions. If you opt for services beyond the initial consultation**, you can get a 25 percent
discount. You also have free access to legal documents and forms on your member website.

Financial services

Call for a free 30-minute consultation for up to three new financial topics*** related to budgeting,
retirement or other financial planning, mortgages and refinancing, credit and debt issues, college
funding, and tax and IRS questions. You can get a 25 percent discount on tax preparation services. You
also have access to financial articles, calculators, and a financial assessment on your member website.

Online resources

The website offers a full range of tools and resources to help with the topics listed above and more.
You’ll find articles and self-assessment, care provider search tool, videos, live and recorded webinars,
and a mobile app You also have access to the Discount Center, where you’ll find deals on brand name
products and services.

Contact Information

Online: resourcesforliving.com
Username: Iron Workers
Password: EAP

Customer Service: 888-238-6232
(TTY users call 711)

Please contact the Benefit Trust Office at 937-454-1744 to determine whether you are eligible for benefits under this Plan. This plan is only available to Active Participants and Dependents. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights, and much more.

Hearing Aid Benefits are provided by the Benefit Trust Office.

Services must be performed and a prescription provided by a licensed physician. Expenses are considered to be incurred on the date the service is provided.

Eligible Hearing Aid Expenses:

• Hearing Aid Exams to determine need for hearing aid(s): Covered once every 24-month period.
• Hearing Aid Instruments: Covered at 80% up to a maximum of $2,000 once every 36-month period.

Benefits are paid based on reasonable charges for you and your family. Please have the provider send a CMS/HCFA 1500 form, or you can submit a detailed receipt/invoice to the Benefit Trust Office.

Please contact the Benefit Trust Office at 937-454-1744 to determine whether you are a current participant under this Plan.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, coverage amount, conversion rights, how to file a claim, and much more.

Life Insurance is provided for our members through MetLife.

Active Iron Workers and Iron Workers on Self-Pay:

• Your Life Insurance Benefit is $7,000
• Your Accidental Death Benefit is $7,000

Active and Self-Pay Iron Workers are eligible for Accidental Death and Dismemberment (AD&D) coverage in addition to Group Life Insurance benefits. For a detailed list of AD&D benefits, please refer to the Benefit Summary Plan Description.

Retired Iron Workers Covered by the Pension Plan:

• Your Life Insurance Benefit is $7,000 (unless your Pension is Deferred or Partial Pro-Rata)
• You are not eligible for AD&D

In the event of a death, beneficiaries should contact the Iron Workers Benefit Trust Office to notify us of the death so we can assist you in filing a claim.

Please contact the Benefit Trust Office at 937-454-1744 to determine whether you are eligible for this benefit. This benefit is only available to Active Participants. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, coverage amount, how to file a claim, and much more.

Weekly Disability Income Benefits are provided for our members through the Benefit Trust Office.

If you become totally disabled, you may be eligible if:

• You are eligible for coverage under the Plan on the date you become disabled;
• You become totally disabled as a result of a non-occupational accidental injury or illness;
• You are under the care of a duly-qualified Physician; and
• Receive certification of the disability from a qualified Physician.

Benefits begin on the:

• First full day of disability due to a non-occupational accident; or
• Eighth day of disability due to illness unless you are inpatient before the eighth day of disability in which case benefits will begin on the day of your inpatient hospital admission.
• The maximum period of disability benefits is 26 weeks for each period of disability for accident or illness; or three weeks for one period of disability per lifetime for inpatient treatment of drug or alcohol-related treatment.

To file a claim, please complete the Weekly Disability Income Claim Form and submit to the Benefit Trust Office.