Northwest Carpenters Health and Security Plan

Summary Plan Description

• Notice
• Statement of Purpose
• Participant Eligibility and Enrollment
  • Introduction
  • Eligible Participants and Dollar Bank Eligibility
  • Enrollment
  • Reciprocity and Money Follows the Carpenter
  • Suspension of Eligibility for Noncovered Employment
  • Termination of Coverage
• Continuation Coverage
  • Introduction
  • Self-Contribution Coverage
  • COBRA Coverage
  • Surviving Dependents
  • Extension of Benefits
  • Family and Medical Leave Act
  • USERRA
• Dependent Eligibility and Enrollment
  • Introduction
  • Eligible Dependents
  • Qualified Medical Child Support Orders
  • Enrollment
  • Loss of Eligibility
• Retiree Eligibility and Enrollment
  • Introduction
  • Eligible Retirees
  • Application Process
  • Monthly Contributions
  • Post-Retirement Service
  • Suspension of Eligibility for Noncovered Employment
  • Special Enrollment Rights
  • Medicare
  • Termination of Retiree Coverage
  • Disclaimer
• Preferred Provider Organization
  • Introduction
  • Aetna Choice POS II Network
  • ID Cards
  • Direct Billing
• Medical Review Programs
  • Introduction
  • Preauthorization
  • Utilization Management
  • Case Management
  • Tobacco Management
• Schedule of Benefits
  • Introduction
  • Annual Deductible
  • Coinsurance
  • Copayments
  • Out-of-Pocket Maximums
  • Medical Plan Maximums
  • Additional Plan Benefits
  • Schedule of Benefits Summary
• Medical Benefits
  • Acupuncture
  • Alternative Care
  • Ambulance Transportation
  • Anesthesia
  • Autism Spectrum Disorder/Pervasive Developmental Disorder
  • Bariatric Surgery
  • Behavioral Health Services
  • Blood
  • Chiropractic Care
  • Dental Accidents
  • Diabetic Care
  • Diagnostic X-Ray and Laboratory Services
  • Durable Medical Equipment
  • Erectile Dysfunction
  • Habilitative Care
  • Hearing Aids
  • Home Health Care
  • Home Phototherapy
  • Hospice Care
  • Hospital Services and Supplies
  • Infusion Therapy
  • Kidney Dialysis
  • Medical Supplies
  • Oral Surgery
  • Orthognathic Surgery
  • Orthotics
  • Physician Services
  • Pregnancy Care
  • Preventive Health Services
  • Prosthetic Devices and Artificial Limbs
  • Reconstructive Surgery
  • Rehabilitative Care
  • Skilled Nursing Facility
  • Sleep Studies
  • Sterilization
  • Telehealth Consultations
  • TMJ and MPDS Treatment
  • Transplants
• Prescription Drug Benefits
  • Introduction
  • Formulary
  • Express Scripts Retail Pharmacy Program
  • Express Scripts By Mail
  • Out-of-Pocket Maximum
  • Nonparticipating Pharmacies
  • Express Scripts Medicare Prescription Plan
  • Step Therapy Program
  • Retail Refill Allowance Program
  • Specialty Medications
  • SaveOnSP
  • Claims Issue
  • Limitations and Exclusions
  • Summary of the Prescription Drug Programs
• Dental Benefits
  • Introduction
  • Delta Dental Provider Networks
  • Delta Dental Customer Service
  • Delta Dental of Washington ID Card
  • Claims and Billing
  • Procedures and Limitations
  • Exclusions
  • Dental Fee Schedule
• Vision Benefits
  • Introduction
  • Vision Benefits
  • VSP Provider Network
  • VSP Customer Service
  • ID Card
  • Claims and Billing
• Time Loss Benefits
  • Introduction
  • How to File a Time Loss Claim
  • Income Tax Withholding
  • Limitations and Exclusions
  • Reinstatement of Benefits
• Life Insurance and Accidental Death and Dismemberment Benefits
  • Introduction
  • Life Insurance Payments
  • Extension of Life Insurance Benefits
  • Accidental Death and Dismemberment Payments
  • Participant's Beneficiary
  • How to File a Claim
  • Purchasing an Individual Life Insurance Policy
  • Termination of Coverage
• Retiree Health Reimbursement Accounts
  • Definitions
  • Accounts
  • Eligibility for Payments from Account
  • How to File an Application
  • Benefits Not Guaranteed
• Claims Process
  • How to File a Medical Claim
  • Claims for Prescription, Dental, Vision, Time Loss, Life Insurance, and Accidental Death and Dismemberment
  • Timely Filing Requirement
  • Coordination of Benefits (COB)
  • 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
• General Limitations and Exclusions
• Important Information
  • Claims and Appeals Rules
  • Life Insurance and Accidental Death and Dismemberment Claims Appeal Procedure
  • Interpretation
  • Rights Under the Employee Retirement Income Security Act (ERISA)
  • HIPAA Privacy Plan Amendment
  • Notice of Privacy Practices
  • Amendment and Termination
  • Benefits Not Guaranteed
  • Nondiscrimination
  • Administrative Information
  • Names, Titles and Addresses of the Board of Trustees

Related Content

• EAP Employee Assistance Program
• Providers
• Member Portal
• Forms
• Updates
   

Partner Websites

• Regence
• Express Scripts
• Delta Dental
• First Choice EAP
• VSP Vision Care
• Quit For Life