Summary Plan Description

Additional Plan Benefits

The following services and supplies are also available but are based on separate benefit maximums or special fee schedules. These benefits are not subject to the annual deductible, coinsurance or copayments. These covered expenses do not apply to the annual out-of-pocket maximums.

Vision Benefits

Routine vision benefits are provided through VSP Vision Care and are based on the benefits and benefit maximums. Vision benefits are not available under the Eastern Washington, Idaho, Montana, and Wyoming benefit package or Retiree Coverage.

Dental and Orthodontic Benefits

Dental benefits are provided through Delta Dental of Washington and are based on a fee schedule with a $2,000 annual maximum for the Western and Central Washington benefit package and a $1,500 annual maximum for the Eastern Washington, Idaho, Montana, and Wyoming benefit package. Dental implants are paid at 50 percent with a lifetime maximum of $1,000 for the Western and Central Washington benefit package only. Orthodontic benefits are paid at 50 percent with a lifetime maximum of $1,500 for participants and dependents under the Western and Central Washington benefit package and with a lifetime maximum of $1,000 for dependent children age 18 and younger under the Eastern Washington, Idaho, Montana, and Wyoming benefit package. Dental benefits are not available under Retiree Coverage.

Time Loss Benefits (Participant Only)

The weekly time loss benefit for the Western and Central Washington benefit package is equal to 33 percent of journeyman pay based on a 40-hour week at the prevailing journeyman's rate specified in the Area Master Agreement signed by your most recent contributing employer. The weekly time loss benefit for the Eastern Washington, Idaho, Montana, and Wyoming benefit package is $100. Time loss benefits are paid for a maximum of 26 weeks. Time loss benefits are not available under Retiree Coverage.

Life Insurance and Accidental Death and Dismemberment

Life insurance and accidental death and dismemberment benefits are available based on the schedules listed. Accidental death and dismemberment benefits are available to participants with dollar bank eligibility only.