Plan A Summary Plan Description

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Table of Contents

  1. YOUR HEALTH and BENEFIT PLAN A EFFECTIVE PLAN YEAR 2014
  2. CLASSES ELIGIBLE FOR COVERAGE
  3. CLASSES NOT ELIGIBLE FOR COVERAGE
  4. ELIGIBILITY FOR BENEFITS
  5. CONTINUATION OF ELIGIBILITY
  6. SELF-PAYMENT
  7. CREDIT
  8. METHOD OF PAYMENT
  9. PLAN A COVERAGE/B CONTRIBUTIONS
  10. NOT AVAILABLE FOR WORK
  11. QUALIFICATIONS FOR RETIREE COVERAGE
  12. RETIRED PENSIONERS – MAINTENANCE OF COVERAGE
  13. RETIREE’S RETURNING TO COVERED EMPLOYMENT
  14. TERMINATION OF COVERAGE
  15. DEFINITIONS
  16. GENERAL EXCLUSIONS
  17. SCHEDULE OF BENEFITS
  18. HOSPITAL COVERAGE
  19. SPECIAL CONDITIONS
  20. MEDICAL BENEFITS
  21. PRESCRIPTION DRUG PROGRAM
  22. PRESCRIPTIONS BY MAIL
  23. PRESCRIPTION DRUG COVERAGE AND MEDICARE
  24. EMPLOYEE ASSISTANCE PROGRAM
  25. ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS
  26. DEATH BENEFITS (Stage 2)
  27. DENTAL BENEFITS (Stage 2)
  28. SCHEDULE OF COVERED DENTAL PROCEDURES
  29. EXTENSION OF BENEFITS
  30. PREFERRED PROVIDER ORGANIZATION DENTAL PLAN (P.P.O.)
  31. VISION CARE BENEFIT FOR PARTICIPANTS (Stage 2)
  32. EXCLUSIONS – VISION
  33. HEARING CARE BENEFIT FOR PARTICIPANTS (Stage 2)
  34. MEDICAL REIMBURSEMENT ACCOUNT
  35. GENERAL PROVISIONS
  36. MEDICARE
  37. RIGHT OF RECOVERY
  38. EXCLUSION OF BENEFITS RECOVERABLE UNDER THIRD-PARTY ACTIONS
  39. NONASSIGNABILITY AND SPENDTHRIFT CLAUSE
  40. CLAIM FILING INSTRUCTIONS
  41. IMPORTANT NOTICE TO ELIGIBLE PARTICIPANTS ON CONTINUATION OF COVERAGE LAW (COBRA)
  42. SUPPLEMENTAL UNEMPLOYMENT BENEFIT PROGRAM
  43. SHORT TERM DISABILITY (LOSS OF TIME)
  44. YOUR RIGHTS UNDER ERISA
  45. SUMMARY PLAN DESCRIPTION
  46. STATEMENT OF PRIVACY PRACTICES
  47. STATEMENT OF ERISA RIGHTS
  48. COMMUNICATIONS
  49. PLAN INTERPRETATIONS AND DETERMINATION
  50. CAUTION