Welfare Plan SPD
Welfare Plan Documents
Eligibility and Enrollment
Retiree Medical Coverage
Self-Pay Premiums
COBRA
Disability Crediting & Waivers
Member Assistance Program
(Actor's Fund)
Welfare Plan Documents & Forms

Summary Plan Description

The Summary Plan Description (also called the SPD), together with the CIGNA booklets for Tiers I, II or III and retiree coverage (see below), describe the key features of the Welfare Fund benefits program. Please note that the SPD and CIGNA booklets were last issued in May of 2006, and have since been modified by amendments and clarifications which can be accessed below.

Plan Changes and Clarifications 

10/06/2006: (1) termination of dental, LTD, life and accidental death and dismemberment insurance benefits; (2) eligibility for retiree benefits
1/10/2007: coverage for dependent children age 19 to 22
6/28/2007: coverage for same-sex partners
6/28/2007: enrollment of eligible children of disabled retirees
11/27/2007: Medicare enrollment
2/11/2008: self-pay premium rates effective 7/01/2008
2/11/2008: CIGNA certificate rider
5/23/2008: legal separation clarification
8/22/2008: apprentice coverage / disability crediting / late fees
3/09/2009: (1) disability crediting; (2) return to employment following retirement; (3) Children’s Health Insurance Program (CHIP)
5/07/2009: post-retirement election
5/07/2009: coverage changes
7/06/2009: new shop provisions
10/7/2009: new shop provisions
10/7/2009: eligibility change
1/01/2010: claim procedure
7/01/2010: self-pay premium and coverage changes

CIGNA Benefits Booklets:

Tier I Coverage
Tier II Coverage
Tier III Coverage
Medicare Eligible (Retiree) Coverage

Benefit Comparison Chart: This is a summary chart that shows the major differences among Tier I, II and III coverage.

Summary Annual Report: This is the most recent basic financial statement sent to participants of the Welfare Funds.

HIPAA Privacy Notice:  This notice describes how medical information about you may be used and disclosed and how to get access to this information.

Forms

CIGNA Claim Form:  This form only needs to be completed if the provider is not submitting the claim on your behalf

Change of Address Form: Please use this form for changes of address or other contact information.

Credit Card Authorization Form:  This form is for authorizing the Welfare Fund to automatically charge your card for future self-pay premiums.

 

News, Notes and Links

 

Terms of Service l Privacy Policy l Site Map

Copyright 2009 Welfare, Pension and Annuity Funds of Local No. One, IATSE
Designed and Developed by Interactive Media Associates