Welfare Trust Fund

The Summary Plan Description and Plan Document

The NECA-IBEW Welfare Trust Fund 2020 Edition Summary Plan Description and Plan Document ("SPD/PD"), as amended, contains complete features of the Base Plan, Alternative Plan, and Supplemental Retirement Plan. Further details related to Plan operations are contained in the Trust Agreement, documents, forms, and other agreements which are used to carry out Plan provisions.

Summary Plan Description/Plan Document

This booklet is called a Summary Plan Description and Plan Document (SPD/PD). This document contains the complete features of the Base Plan, Alternative Plan, and the Supplemental Retirement Plan.

View SPD/PD

Schedules of Benefits

The Schedules of Benefits for all Plans (Base, Alt, Retiree) summarizes the dollar benefits, quantity limits, deductibles, and co-insurance for each Plan.

View Schedules of Benefits

Newsletter

Newsletters contain messages from the Trustees, benefit notes and changes, and important information about your privacy and keeping your contact information current. Newsletters are generally released twice per year after the bi-annual Trustees Meetings. 

View Latest Newsletter

  

The SPD/PD is amended from time to time and is restated generally every five years. This SPD/PD, as amended, supersedes any previous SPD/PD. If the Plan is amended or modified, you will receive written notice of such changes in the form of a newsletter or Summary of Material Modifications (“SMM”). The Fund’s regular newsletters act as SMMs. These Plan change notices can be found in the Documents and Forms Library, in the Newsletters category, and should be kept with your SPD/PD.

Links to the Plan Amendments are listed below.

Amendment 1: Death/ADD/Disability benefits, Allowable Charges, and telemedicine

Amendment 2: Retiree Eligibility, the Voluntary Hours Donation Program, telemedicine, and reciprocity

Amendment 3: Additions to the SPD/PD Definitions, Surprise Medical Bills, and other patient protections

Amendment 4: Coverage of Speech and Occupational Therapy, COVID-19 testing

Amendment 4, Exhibit A: Changes to Schedules of Benefits as related to Amendment 4

Amendment 5: Medicare Advantage Plan and Retiree benefits

Amendment 6: Occlusal guards

Amendment 7: Voluntary Hours Donation Program

Amendment 8: 

Amendment 9: Changes to Covered Medical Expenses

Amendment 10: HIPAA privacy and security rule compliance

Amendment 11: Initial Eligibility and self-payments

Amendment 12: Deadline waiver requests


  

Health and Welfare Plan Benefits

A current Data Claim Statement (Data Card) is required to avoid any delays in processing your claims. For your convenience, the Data Card can be printed from this website; you can then complete and return the completed Data Card to NECA-IBEW by fax or postal mail. Please do not email the Data Card as it contains private information and email may not be HIPAA-compliant.

 

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Medical Benefits

A Preferred Provider Organization (PPO) is a group of physicians and hospitals that have negotiated a contract with the Welfare Trust Fund to provide discounts to members.

Physicians and hospitals that participate in the PPO Network are known as PPO Providers. BlueCross BlueShield is the Plan’s current PPO Network.

  Find a BCBS Provider

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Dental Benefits

The Welfare Trust Fund has an agreement with a Preferred Provider Dental Organization (PPDO), Guardian DentalGuard Preferred Select. You and your dependents may choose dental treatment provided by the PPDO or non-network providers. PPDO providers have negotiated discount prices with Guardian Dental. By using a PPDO provider, you will gain more services for your dental maximum.

  Find a Guardian Network Provider

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Vision Benefits

EyeMed is the vision care network that administers a network of vision care providers (known as the "Insight Network") on behalf of the Fund. Participants and Dependents eligible for vision benefits can choose to go to a provider in the EyeMed Insight network and receive discounts on services and materials, such as exams, frames, lenses, and contacts.

Find an EyeMed Provider

 

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Prescription Benefits

Prescription Drug Benefits are available to all employees and their eligible dependents. The Plan’s Prescription Drug Benefits are provided through MedImpact.

MedImpact

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Employee Assistance Program

The Employee Assistance Program (EAP), through TELUS Health, is a free resource to help Fund Participants and Dependents manage issues affecting their work or personal life, such as mental and behavioral health, substance abuse, financial wellbeing, and more. The Fund covers up to three free EAP visits per year.

Telus Health

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EPIC Hearing

The Welfare Trust Fund, in partnership with EPIC Hearing Service Plan, assists active participants and pre-Medicare retirees* in locating hearing care professionals and, in most cases, reducing out-of-pocket expenses for hearing exams and hearing aid devices.

EPIC Hearing

  

 

Welfare Trust Fund Documents & Forms

Welfare Trust Fund Documents

Welfare Trust Fund Forms

  • Data Card
    The Data Card is the annual enrollment form that must be completed for claims to be processed. The Data Card can be completed on the MemberXG portal, or by completing and submitting this paper form to the Fund Office.
  • Appeal Form/Authorized Representative Form-Welfare Trust Fund
    This appeal form is used to request a review of an adverse benefit determination by the Welfare Trust Fund.
  • Authorized Representative Designation Form
    This form is used to appoint a personal or authorized representative to receive your personal health information.
  • Beneficiary Designation Form-Welfare Trust Fund
    This form is used to specify your beneficiary, or beneficiaries, for applicable benefits provided by the Welfare Trust Fund.
  • Continuity of Care Benefits Request and Release of Information Form
    The form to use to request Continuity of Care Benefits, to use when your in-network provider goes out-of-network; conditions apply.
  • Customer Service Consent (HIPAA Form)
    This form is used to give permission to the Fund Office to discuss your benefits with another entity.
  • Dependent Accident Form
    The form that is used to report an incident related to an injury for a dependent. Participants may receive multiple copies if there are many associated claims; this form only needs to be completed once per incident that caused the injury.
  • Direct Transfer Form
    This form is used to give permission to the Fund Office to transfer funds directly from your Health Reimbursement Account (HRA) to make payments to the Fund Office for retiree premiums or COBRA/self-pay payments.
  • Hours Transfer Form
    This form is used to indicate that you wish to donate hours in your hour bank, under the Voluntary Hours Donation Program, to a fellow participant who is unable to work due to a catastrophic illness or injury of the Participant or the Participant's immediate family.
  • Member Accident Form
    The form that is used to report an incident related to an injury. Participants may receive multiple copies if there are many associated claims; this form only needs to be completed once per incident that caused the injury.
  • Other Liability Insurance Form
    The Fund Office may request that this form be completed if medical expenses due to an incident that causes an injury may be the responsibility of a third-party or other insurance.
  • Physician's Statement for Loss of Time from Work
    The form that a physician completes to document an incident or loss of time from work.
  • Specific Information Release
    This form is used to authorize the use or disclosure of your individually identifiable health information to specified providers or designated representatives.
  • Spousal and Dependent Insurance Form
    This form is to be completed by a spouse/dependent's employer, to specify if the spouse/dependent is offered insurance through their employer.
  • Subrogation Agreement and Loan Agreement
    This form is sent to claimants when the incident that caused a participant to incur medical expenses may be the responsibility of a third party.
  • Vision Benefit: EyeMed Reimbursement Form for Out-of-Network Claims
    The form to use to request reimbursement for out-of-network vision expenses; this form should be submitted to EyeMed, not the Fund Office.
  • Wellness Power: Biometric Form 2023
    A form for your Physician to complete and submit to the Wellness Power program, to earn the biometric Wellness reward.
  • Wellness Power: Biometric Form 2024
    A form for your Physician to complete and submit to the Wellness Power program, to earn the biometric Wellness reward for 2024.

  

Welfare Trust Fund FAQs

Your coverage and benefits can be affected by Life Events.