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   Summary Plan Description
 
Notice
Statement Of Purpose
Eligibility And Enrollment
Introduction
Eligible Retirees
Eligible Dependents
Enrollment Process
Enrollment Documentation
Monthly Contributions
SecureHorizons
Special Enrollment Rights
Suspension of Coverage
Termination of Coverage
Benefit Portability
COBRA Continuation Coverage
How the Plan Works
Introduction
Annual Deductible
Copayments
Coinsurance
Additional Out-of-Pocket Expenses
Medical Plan Maximums
Life Insurance Benefits
Benefit Summary
Preferred Provider Organization (PPO)
Introduction
ID Card
Preferred Providers
Direct Billing
Medical Review Program
Introduction
Preadmission Certification Program
Second Surgical Opinion Program
Medical Case Management Program
Medical Benefits
Ambulance Transportation
Anesthesia
Autism Spectrum Disorders
Blood
Chemical Dependency
Chiropractic Care
Dental Accidents
Diabetic Care
Diagnostic X-Ray and Laboratory Services
Durable Medical Equipment
Erectile Dysfunction
Home Health Care
Home Phototherapy
Hospice Care
Hospital Services and Supplies
Infusion Therapy
Kidney Dialysis
Medical Supplies
Mental Health Care
Neurodevelopmental Therapy
Neuropsychological or Psychological Assessments or Tests
Oral Surgery
Physical Examinations
Physician Services
Pregnancy Care
Prosthetic Devices and Artificial Limbs
Reconstructive Surgery
Rehabilitative Care
Religious Nonmedical Health Care Institutions
Routine Immunizations
Screening Tests
Skilled Nursing Facility
Sleep Studies
Sterilization
Surgery
Tobacco Cessation Program
Transplants
Prescription Drug Benefits
Introduction
Medco Health Retail Pharmacy Program
Medco By Mail
Preferred Prescriptions Incentive Formulary
Nonparticipating Pharmacies
Limitations and Exclusions
Medco Medicare Prescription Plan
Summary of the Prescription Drug Programs
Life Insurance Benefits
Introduction
Life Insurance Benefits For Retirees
Life Insurance Benefits For Dependents
Retiree's Beneficiary
Surviving Dependent's Beneficiary
How To File A Life Insurance Claim
Purchasing An Individual Life Insurance Policy
Termination Of Coverage
Retiree Health Reimbursement Accounts
Definitions
Accounts
Eligibility For Payments From Account
How to File a Claim
Claims Process
How To File A Claim
Timely Filing Requirement
Coordination Of Benefits (COB) With Other Plans and Medicare
Facility of Payment
Trust's Right to Reimbursement
Right to Receive and Release Necessary Information
No Waiver of Claim Paid In Error - Recovery By Trust
Misrepresentation
Assignment
Glossary Of Terms
General Limitations And Exclusions
Important Information
Claims and Appeals Rules
Life Insurance Claims Appeal Procedure
Rights Under The Employee Retirement Income Security Act (ERISA)
HIPAA Privacy Plan Amendment
Notice of Privacy Practices
Amendment and Termination
Benefits Not Guarenteed
Administrative Information
Names, Titles and Addresses of the Board of Trustees
 

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