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 2011, and have since been modified by amendments and clarifications which can be accessed below.

Plan Changes and Clarifications 

12/16/2011:  retiree family member coverage

01/01/2012:  nutritional visits and retiree family member coverage

07/01/2012:  self pay rate and specialist copay

03/01/2013:  affordable care act changes

01/01/2014:  self pay rate and covered earnings requirements

CIGNA Benefit Descriptions:

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

CIGNA Summary of Benefits and Coverage:

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