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Atlanta Plumbers & Steamfitters Local 72 Fringe Benefit Funds

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Atlanta Plumbers & Steamfitters Local 72 Fringe Benefit Funds Atlanta Plumbers and Steamfitters Health and Welfare Fund c/o National Employee Benefits Administrators, Inc. 1 (888) 365-0072 To: Active Plan Participants Board of Trustees From: Board of Trustees Union Trustees Date: November 15, 2020 Mr. Jeff Housworth RE: Important Announcement regarding Dependent Coverage Co-Chairman UA Local Union 72 IMPORTANT ANNOUNCEMENT ABOUT YOUR HEALTHCARE Mr. Terry Newsome, Jr. BENEFITS UA Local Union 72 The Board of Trustees of the Atlanta Plumbers & Steamfitters Health and Mr. Steve Newsome Welfare Fund (“the Fund”) has established a special committee to work on UA Local Union 72 improving participants’ experience with using their benefits. The committee Mr. Jarrett Wade has met numerous times over the course of the 2020 plan year and will UA Local Union 72 continue to meet to evaluate and simplify plan rules and requirements, with the objective of providing participants with a more convenient experience. Mr. Alan Tomberlin UA Local Union 72 Dependent Coverage Contribution Requirements Employer Trustees The Trustees recognize that the initial process that was established for Mr. Jon Sterling collecting dependent coverage contributions has, at times, led to Co-Chairman dissatisfaction from plan participants. The Trustees are pleased to announce Maxair Mechanical, Inc. revised dependent coverage contribution guidelines that have been Mr. Andy Sumpter established to address this challenge. Mechanical Contractors Association of Georgia What’s Changing Mr. Ken Harbour Cleveland Mechanical Services Initial Dependent Coverage: When a participant completes the enrollment process to add new dependents, such as a new spouse or new Mr. John McKenney dependent child, eligible dependents will be enrolled in the plan without McKenney’s Inc. requiring that dependent coverage contributions be received in advance. Mr. James K. Estabrook Lindabury, McCormick, How does this help? Previously, participants had to remit their dependent Estabrook & Cooper, P.C. coverage contributions before their dependents could be covered, which ADMINISTRATIVE MANAGER: National Employee Benefits Administrators, Inc. 1.888.365-0072 (Toll Free) • 954.266.6322 • 954.266.2079 (Fax) www.nebainc.com 2010 N.W. 150th Ave, Suite 100 374 Maynard Terrace, S.E., Suite 72 3715 Northside Parkway, Suite 2-495 Pembroke Pines, FL 33028 Atlanta, GA 30316 Atlanta, GA 30327 Atlanta Plumbers and Steamfitters Health and Welfare Fund c/o National Employee Benefits Administrators, Inc. 1 (888) 365-0072 sometimes led to delays in getting new dependents covered. This new process will eliminate these delays. Continuing Dependent Coverage: If a participant has an interruption in their dependent coverage contributions, dependent coverage will not be immediately lost. How does this help? Previously, if the full amount due for each month was not received, dependent coverage was dropped until the participant self-paid the contributions owed. This happened for a variety of reasons, including participants being out of work, participants taking vacation time, deduction errors at participants’ employers, etc. Under the new requirements, participants will still owe the same amount for the coverage; however, participants will have until December 15th each year to pay any shortages due that have accumulated throughout the year. This new process will eliminate the interruptions in dependent coverage due to missed contributions. NEBA will continue to provide periodic self-pay statements for dependent contributions owed and the Trustees encourage participants to pay shortages due as soon as possible to avoid accumulating a large self-pay amount due at the end of the year. Dependent Coverage Contribution Reconciliation for Participants with Dependents Each year, NEBA will review each participant’s dependent contribution history for the 12-month period beginning November 1 of the prior year through October 31 of the current year, to determine if there are any shortages due. One month of dependent contributions will be owed for each month of dependent coverage that was provided during the current year. Following this review, NEBA will notify each participant that has a dependent contribution shortage with a statement of amounts due. Participants must submit payment for amounts due no later than December 15th. Dependent coverage will terminate on December 31st for Participants who do not remit the amounts due by December 15th. Dependent coverage that has been terminated due to non-payment may only be reinstated under the limited circumstances outlined on the next page. ADMINISTRATIVE MANAGER: National Employee Benefits Administrators, Inc. 1.888.365-0072 (Toll Free) • 954.266.6322 • 954.266.2079 (Fax) www.nebainc.com 2010 N.W. 150th Ave, Suite 100 374 Maynard Terrace, S.E., Suite 72 3715 Northside Parkway, Suite 2-495 Pembroke Pines, FL 33028 Atlanta, GA 30316 Atlanta, GA 30327 Atlanta Plumbers and Steamfitters Health and Welfare Fund c/o National Employee Benefits Administrators, Inc. 1 (888) 365-0072 Conditions for Re-Enrolling Dependent Children or Spouse After Lapse in Coverage Due to Non-Payment A participant may re-enroll a Dependent child or spouse after a lapse in coverage due to non-payment of dependent contributions, provided that the Dependent child or Dependent spouse otherwise meets the remaining Plan eligibility requirements as of the enrollment date, and the following conditions are met: The participant remits payment in full for all outstanding dependent coverage contributions; and, the participant becomes newly eligible for benefits after a lapse in coverage, pursuant to the reinstatement of eligibility rules; or the Dependent child or Dependent spouse would otherwise be eligible to enroll during a subsequent open enrollment period; or the Dependent child or Dependent spouse becomes eligible for a special enrollment right pursuant to the Health Insurance and Portability Act. Enclosed with this memorandum is a Summary of Material Modifications (SMM) which describes these changes in detail. The SMM should be kept with your Summary Plan Description (SPD). As always, please feel free to call the Plan’s Third Party Administrator, National Employee Benefits Administrators, Inc. (“NEBA”) at (888) 365-0072 with any questions. ADMINISTRATIVE MANAGER: National Employee Benefits Administrators, Inc. 1.888.365-0072 (Toll Free) • 954.266.6322 • 954.266.2079 (Fax) www.nebainc.com 2010 N.W. 150th Ave, Suite 100 374 Maynard Terrace, S.E., Suite 72 3715 Northside Parkway, Suite 2-495 Pembroke Pines, FL 33028 Atlanta, GA 30316 Atlanta, GA 30327 Atlanta Plumbers and Steamfitters Health and Welfare Fund c/o National Employee Benefits Administrators, Inc. 1 (888) 365-0072 Summary of Material Modifications – January 1, 2021 This document is a “Summary of Material Modifications” (SMM) which describes changes to the Atlanta Plumbers and Steamfitters Health and Welfare Fund (the “Fund”). This SMM modifies the language found in your Summary Plan Description (SPD). All statements made in this document are subject to the terms and conditions of the Plan Document. If there is a discrepancy between the SPD or this SMM and the Plan Document, the Plan Document will govern. Copies of the SPD and Plan Document are available for review at any time during normal working hours at NEBA’s offices. Dependent Eligibility The eligibility rules of the Fund have been revised to reflect the following requirements for dependents. Dependent Child A Dependent child of an Employee who becomes eligible for benefits shall become eligible for benefits for each month beginning as of the date upon which the Employee first becomes eligible for benefits and enrolls the Dependent child, if any required contribution is made to the Trust on behalf of the Dependent child for each such month; provided, that if any such required contribution is not paid for any applicable month or months, coverage for the Dependent child shall continue during the month or months for which the required contribution has not been paid. The total amount of any unpaid monthly contributions for a Plan Year shall be due and payable on or before the December 15 of the year in which the monthly contributions are due. In the event that unpaid monthly contributions are not paid by the applicable December 15, the Dependent child will not be eligible to receive coverage under the Plan for any subsequent Plan Year during which the monthly contributions remain unpaid, and shall not again become eligible to enroll in the Plan until the date upon which the past due contributions are paid in full and either: (A) the Employee again becomes eligible for benefits after a lapse in coverage, pursuant to the reinstatement of eligibility rules; (B) the Dependent child would otherwise be eligible to enroll during a subsequent open enrollment period; or (C) the Dependent child becomes eligible for a special enrollment right pursuant to the Health Insurance and Portability Act; provided, that the Dependent child otherwise meets the remaining Plan eligibility requirements as of the enrollment date. ADMINISTRATIVE MANAGER: National Employee Benefits Administrators, Inc. 1.888.365-0072 (Toll Free) • 954.266.6322 • 954.266.2079 (Fax) www.nebainc.com 2010 N.W. 150th Ave, Suite 100 374 Maynard Terrace, S.E., Suite 72 3715 Northside Parkway, Suite 2-495 Pembroke Pines, FL 33028 Atlanta, GA 30316 Atlanta, GA 30327 Atlanta Plumbers and Steamfitters Health and Welfare Fund c/o National Employee Benefits Administrators, Inc. 1 (888) 365-0072 Dependent Spouse A Dependent
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