Open Enrollment 2018 Information

Open Enrollment Period

November 1, 2017 through November 30, 2017


Dates to Remember


All Changes, Single with Dependents & Opt-out Elections Due By:

Thursday, November 30, 2017


Effective Date for Changes:

January 1, 2018

Dear Health and Welfare Participants:


The Open Enrollment period for the IBEW Local No. 43 and Electrical Contractors Health and Welfare Plan is from November 1, 2017 to November 30, 2017 for coverage effective January 1, 2018. The member healthcare premium cost and enrollment instructions are outlined in the enclosed document.


You will note that there is an increase in the member contribution requirement beginning January 1, 2018. This is the result of health care costs which have been increasing substantially over the years. To put the increased costs in perspective, the IBEW Local 43 Welfare Fund will spend more than $15.2 million on member benefits this year compared to $14.2 million last year.


You are encouraged to carefully review the enrollment instrucons, including those related to the Health Reimbursement Accounts (HRA) as the regulaons pertaining to the HRA have changed. Specifically, if you are enrolled in single coverage or opt-out of medical coverage, and want your HRA allocaons to be available for qualifying expenses incurred by eligible dependents, you must provide evidence (as indicated on the enclosed forms) that those dependents are enrolled in other employer- sponsored minimum value group health coverage.


As always, if you have questions or need assistance, please call the Fund Office at (315) 474-5729. We will be glad to be of help.


Very truly yours,

BOARD OF TRUSTEES


INTERNATIONAL BROTHERHOOD OF
ELECTRICAL WORKERS LOCAL NO. 43
AND ELECTRICAL CONTRACTORS
WELFARE FUND

EFFECTIVE JANUARY 1, 2018

HEALTH BENEFIT PREMIUM RATES BY COVERAGE TYPE

Single $500.00

Family: $1,075.00

Opt-Out of coverage: $100.00


The coverage types listed above include the following benefits:

Short-Term Disability for Occupational and Non-Occupational Sickness or Inquiry

Life Insurance: $50,000 Death Benefit

Accidental Death & Dismemberment (AD&D): up to $50,000

Employee Assistance Program (EAP): at no cost to you or your family

Health Reimbursement Account (HRA)


Benefit premium costs are not deducted from your weekly paycheck.


  1. If you wish to contine your Single or Family coverage election “as is” no further action is required by you. However, if you have Single coverage and have eligible dependents, please see Single Coverage WITH Dependents - Must be renewed annually

  2. If you wish to elect coverage, change coverage, or add an eligible dependent you must act now. If you fail to make your changes on or before November 30, 2017 your next opportunity to do so will be during the next Open Enrollment period November 2018 unless you have a qualifying life event change. Please see Electing Coverage or Making Changes to Your Single or Family Coverage Option

  3. If you wish to opt-out of coverage, please see Opt-Out-Of Coverage - Must be renewed annually See the Gold Box above for Dates to Remember.

If you are electing coverage or changing your coverage option (from Single to Family or Family to Single) or adding/dropping a dependent to or from your medical plan, you must:

  1. Complete and return the IBEW Local No. 43 Health and Prescription Benefit Enrollment Form;

  2. For each new dependent, you must include their name, date of birth, Social Security number, gender, copy of birth certificate and if adding a spouse, a completed Spousal Affidavit form and marriage certificate.

  1. You must confirm on the Waiver (Opt-Out) of Participation form that your eligible dependents are enrolled in group coverage that meets the Patient Protection Affordable Care Act “minimum value” criteria. To validate that your dependent has group coverage that meets the minimum value criteria you must submit a copy of your spouse’s employer’s current Group Health Insurance Plan’s Summary of Benefits and Coverage (SBC) and a photocopy of the Group Health Insurance ID Card.

  2. If the above documentation is not available, you must submit a letter from the applicable employer confirming the group coverage.

  3. For each dependent for whom you intend to seek reimbursement from your HRA, you must also include their name, date of birth, Social Security number, gender, copy of birth certificate and if adding a spouse, a marriage certificate.

You may elect the Opt-Out of Coverage (Waiver of Participation) if you have medical coverage through your spouse’s employer or if you have medical coverage through your employment with another employer. In addition, you must confirm and provide the following documentation:


  1. Complete and return the Waiver (Opt Out) of Participation in the IBEW Local No. 43 Welfare Fund Group Health Plan form.

  2. You must confirm you are enrolled in group coverage that meets the Patient Protection Affordable Care Act “minimum value” criteria. To validate that you have group coverage that meets the minimum value criteria you must submit a copy of your spouse’s or your own other employer’s current Group Health Insurance Plan’s SBC and a photocopy of your current Group Health Insurance ID Card. If the above documents are not available, a letter from your spouse’s employer or your own other employer confirming your coverage must be submitted.

  3. For each dependent for whom you intend to seek reimbursement from your HRA, you must include their name, date of birth, Social Security number, gender, copy of birth certificate and if adding a spouse as a dependent, a marriage certificate. You must also submit an SBC and Health Insurance I.D. card establishing each dependent’s other group health coverage. If the SBC and I.D. Card are not available, you must submit a letter from the employer confirming the coverage.

You may also choose to “Opt-out” of medical coverage and to waive all future reimbursements from your Health Reimbursement Account (HRA) benefits offered through the Fund Office annually. Although “opting-out” of ALL Fund coverage is not recommended, because you will be choosing to decline all medical coverage and Health Reimbursement (HRA) benefits despite the fact that contributions will continue to be made to the Fund for your work in covered employment, the Fund will comply with this requirement as part of implementing the healthcare reform laws. Once such election is made, it is irrevocable and cannot be changed until the 2018 Open Enrollment Period. To completely decline Fund benefits, contact the Fund Office for pertinent documents. You should carefully consider the consequences of declining all medical and Health Reimbursement Account (HRA) benefits, and you should discuss any such decision with your tax advisor.

The Fund Office will not process claims for you or your dependents until the Fund receives the necessary enrollment forms. Until the completed forms are received by the Fund Office, the Fund’s Trustees reserve the right to suspend claim payments.


I.B.E.W. Local 43 and Electrical Contractors Trust Funds
PO Box 2218 - Syracuse, New York 13220-2218
(315) 474-5729 - (800) 474-5744
FAX (315) 474-1588

This notice contains important information regarding your Welfare Fund benefits

Date: October 2017

To: International Brotherhood of Electrical Workers Local No. 43 and Electrical Contractors
Welfare Fund
Participants and their covered dependents
All retirees and their covered dependents
All COBRA participants

From: The Board of Trustees
Notice of Grandfathered Health Plan

International Brotherhood of Electrical Workers Local No. 43 and Electrical Contractors Welfare Fund believe this plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when the law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.


Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at (315) 474-5729. You may also contact the Employee Benefit Security Administration U.S. Department of Labor at 1-866-444-3272 or https://dol.gov/ebsa/healthcarereform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.

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