Summary Plan Description

Administrative Information

A. Plan Name

The plan is known as the Carpenters Health and Security Plan of Western Washington. This plan booklet describes benefits available to participants and their dependents.

B. Name, Address and Telephone Numbers of the Joint Board of Trustees

The plan is sponsored by a joint labor-management board of trustees. The Board's name, address and telephone number are:

Board of Trustees
Carpenters Trusts of Western Washington
2200 Sixth Avenue, Suite 300
Seattle, WA 98121-1839
(206) 441-6514 Seattle Area
(800) 552-0635 Nationwide

You and your dependents may obtain a complete list of the employers and employee organizations sponsoring the plan by written request to the Trustees. You may also examine this information at Carpenters Trusts or your Local Union upon ten days advance written request. The Trustees may impose a reasonable charge to cover the cost of furnishing these lists, and you may wish to ask the amount of the charges before requesting copies.

C. Identification Number

The Internal Revenue Service employer identification number assigned to your plan is 91-6029049. In accordance with IRS instructions, the Trustees have assigned this plan the identification number of 501.

D. Type of Plan

The Carpenters Health and Security Plan is a welfare plan which provides medical, surgical, hospital, prescription, vision, dental, time loss, life insurance, and accidental death and dismemberment benefits.

E. Type of Administration

The plan is administered by a joint labor-management board of trustees with the assistance of a salaried administrator.

F. Name, Address and Telephone Numbers of the Salaried Administrator

Randy S. Parker
Carpenters Trusts of Western Washington
2200 Sixth Avenue, Suite 300
Seattle, WA 98121-1839
(206) 441-6514 Seattle Area
(800) 552-0635 Nationwide

G. Description of Collective Bargaining Agreements

The plan is maintained according to the terms of collective bargaining agreements. You and your dependents may obtain a copy of an agreement by writing to the Trustees. You may also examine an agreement at Carpenters Trusts or your Local Union upon ten days advance written notice. The Trustees may impose a reasonable charge to cover the cost of furnishing an agreement and you may wish to ask the cost before requesting copies.

H. Eligibility and Benefits

You are entitled to participate in this plan if you work under a collective bargaining agreement described in item G above or a written contribution agreement, and if your employer makes contributions to the Trust Fund on your behalf. The eligibility rules determine which participants and dependents are entitled to benefits. Click here for the suspension of eligibility and termination of coverage rules are described here. The benefits to which participants and dependents are entitled are listed here.

I. Source of Contributions

The Carpenters Health and Security Plan of Western Washington is funded by employer contributions. The amount of these contributions is specified in the collective bargaining agreements described in item G above or a written contribution agreement. Self-payments are also permitted for continuation coverage. See Self-Contribution Coverage, COBRA Coverage and Retiree Coverag. Procedures for filing claims are located here.

J. Entities Used For Accumulation of Assets and Payment of Benefits

Contributions paid into the plan to obtain benefits are received and held in trust by the Board of Trustees, pending payment of benefits, administrative expenses, and life insurance and accidental death and dismemberment premiums to the life insurance company.

The Board of Trustees pays benefits directly from the Trust Fund, with the exception of life insurance and accidental death and dismemberment benefits which are insured by LifeMap.

The following are the names and addresses of issuers under contract with the plan:

Aetna Inc.
151 Farmington Avenue
Hartford, CT 06156
A preferred provider organization that provides network management and manages utilization management programs.
Alere Wellbeing
999 Third Avenue, Suite 2100
Seattle, WA 98104
A tobacco cessation program.
Delta Dental of Washington
PO Box 75983
Seattle, WA 98175
A dentist and orthodontist network.
Diplomat
G3320 Beecher Road
Flint, MI 48532
A prescription benefit manager that provides specialty medications.
Envolve PeopleCare
20 Batterson Park Road
Farmington, CT 06032
A condition management company that administers the disease management program.
Express Scripts Health Solutions, Inc.
PO Box 14711
Lexington, KY 40512
A prescription benefit manager that provides pharmacy network management.
Express Scripts Health Solutions of Fort Worth
PO Box 650332
Fort Worth, TX 75265-9946
A prescription benefit manager that provides mail service pharmacy management.
LifeMap Assurance Company
PO Box 1271
Portland, OR 97207-1271
A life and health insurance company that provides fully insured life insurance benefits and administers those benefits.
VSP Vision Care
3333 Quality Drive
Rancho Cordova, CA 95670
An optometrist and optician network.

K. Plan Year

January 1 through December 31.

L. Agents For Legal Process

Randy S. Parker
Carpenters Trusts of Western Washington
2200 Sixth Avenue, Suite 300
Seattle, WA 98121-1839
(206) 441-6514 Seattle Area
(800) 552-0635 Nationwide