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7570 Caple Blvd
Northwood, OH 43619-1084, US
419-662-5456
Fax 419-662-4534
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Dental
and Eye | Physicals | Prescriptions
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HEALTH AND WELFARE BENEFITS
Comprehensive Hospital and Medical Benefits
– Effective
Jan. 1, 2004
80/20 Basic Medical Coverage (plan covered doctors and hospitals)
Deductible per eligible person per calendar year--------$400
Maximum deductible per family per calendar year------$1,200
Maximum co-payment per person per calendar year----$1,500
Maximum co-payment per family per calendar year----$3,000
Maximum benefit per eligible person, per lifetime-------$2,000,000
Eligibility requires 135 hours of work hours to
qualify. A reserve bank is established with surplus hours building up to a maximum of 1
year.
Prescription
Benefit
The Trustees have retained Scriptsense to administer your prescription benefit program.
In addition to a new prescription benefit manager, a three tier co-payment will be
implemented, as follows:
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Co-payment Per Prescription
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Retail
(up to
a 34 day supply)
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Mail
Order
(up to
a 90 day supply)
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Generic Drug
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$10
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$20
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Preferred Drug
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$20
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$40
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Non-Preferred Drug
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$35
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$70
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***** Supplemental Reserve Account *****
(Medical Savings Account)
$1.15 an hour is contributed - approximately
$2,000 is contributed annually
Money is non-taxable and can be used to make co-pay or self-payment
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Dental
and Eye coverage is a maximum benefit of $750 per year, per family
Preventive Health
Benefit Plan - Physicals
100%
covered and not subject to annual deductibles or lifetime maximum
Children
2
weeks, 2 months, 4 months, 6 months, 9 months, 15 months, 18 months,
2
years, 3 years, 4 years, 5 years, 6 years, 8 years, 10 years, 12 years,
14
years, 16 years
Adults
18-50 years --- Visits every other year
Over
50 years --- Visits every year
After 10 years of service Health and Welfare
benefits are available after Retirement.
Death Benefit
Active Member
-- $2,000 from Health & Welfare fund
$2,000 from Local 50
up to $2,500 from UA based on years of service
Retirees
-- $1,000
Loss of time benefit: Active Member -- $450.00 for maximum of 26 weeks
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