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Benefit List for all three plans as of January 1, 2013 Wellness Benefits

IBEW-NECA Southwestern Health & Benefit Fund Current Benefits Levels – Regular; Sub-Plan 1 & Sub-Plan 2. Benefit List for all three plans as of January 1, 2013 Wellness Benefits Prescription, Dental and Mental Coverage Regular Plan Eligibility & Hour Bank

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Benefit List for all three plans as of January 1, 2013 Wellness Benefits

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  1. IBEW-NECA Southwestern Health & Benefit Fund Current Benefits Levels – Regular; Sub-Plan 1 & Sub-Plan 2 Benefit List for all three plans as of January 1, 2013 Wellness Benefits Prescription, Dental and Mental Coverage Regular Plan Eligibility & Hour Bank Sub-Plan Eligibility & 1 Month Hour Bank This is not a guarantee of benefits. For a more accurate explanation of benefits refer to the Summary Plan Description

  2. Benefits List as of 9/1/11 1 of 7

  3. Benefits List 2 of 7

  4. Benefits List 3 of 7Wellness Benefits

  5. Benefits List 4 of 7Wellness Benefits

  6. Regular Plan 5 of 7Prescription Drug Details

  7. Regular Plan 6 of 7Dental Coverage as of 9/1/11 MAXIMUM PAYBALE FOR EACH CONTRACT YEAR IS $1000 PER ENROLLEE

  8. Eligibility Example – Regular Plan with Hour Bank MAXIMUM HOUR BANK IS 700 HOURS – EQUALS 5 MONTHS ELIGIBILITY

  9. Eligibility Example – Sub-Plan with One Month Hour Bank

  10. www.abpa.com

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