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 AETNA 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 was last issued in May of 2016.

Plan Changes and Clarifications

05-06-2016 elimination of age 26-29 coverage

10-31-2016 change in tier III eligibility

01-01-2018 self-pay premium rates and various coverage changes

03-23-2018 tier III eligibility and various coverage changes

06-01-2018 enrollment changes, births

12-01-2018 various coverage changes

01-01-2019 self-pay premium rates changes

12-01-2019 fmla and gene therapy

01-01-2020 self-pay premium rates and various coverage changes

03-20-2020 defer self-pay

07-01-2020 recovery tier

01-01-2021 medicare advantage

02-08-2021 eligibility

07-01-2021 eligibility, self-pay rates, retiree

01-01-2022 eligibility, self-pay rates, disability

04-01-2022 eligibility changes

07-01-2022 eligibility changes

07-01-2022 gene therapy

07-01-2022 no surprise act

01-01-2024 medicare advantage

07-01-2024 eligibility changes

 

Benefit Descriptions:

Basic Tier Summary of Benefits

Tier I  Summary of Benefits

Tier II  Summary of Benefits

Tier III Summary of Benefits

AETNA Recovery Tier Plan Choice POS II

AETNA Recovery Tier Plan Schedule of Benefits

AETNA Recovery Basic Tier Plan Choice POS II

AETNA Recovery Basic Tier Schedule of Benefits

 

Benefit Summary Chart: The following chart summarizes the benefits the Welfare Plan will provide for the all eligible participants.

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:

Spousal Coverage Confirmation:  This form only needs to be completed if you have elected medical coverage for your spouse.

AETNA 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.

 

 

News, Notes and Links

  • Visit aetna.com for health insurance coverage information.
  • Visit express-scripts.com for pharmacy benefit information.
  • ER Alternatives: What are your options?
  • Please note that nothing on this website is intended to interpret, extend or change in any way the provisions expressed in the Summary Plan Description and any other Plan documents. If you have any questions regarding your particular situation, please contact the Fund Office for more information.
 

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