Service Employees 32BJ North Health Fund

Tri-State Preferred North Summary Plan Description (SPD) >> Retiree Health Benefits

• Eligibility         ALERT: 06/10/10 NEW Click here for important benefit changes>>
• Benefits         ALERT: 06/10/10 NEW Click here for important benefit changes>>
• Participants and Dependents Under Age 65
• Participants and Dependents Age 65 and Older
• How The HRA Works         ALERT: 06/10/10 NEW Click here for important benefit changes>>
• Annual and Lifetime Maximums         ALERT: 06/10/10 NEW Click here for important benefit changes>>
• Administrative Fees         ALERT: 06/10/10 NEW Click here for important benefit changes>>
• Termination         ALERT: 06/10/10 NEW Click here for important benefit changes>>

Eligibility

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You are eligible to receive retiree health benefits from the Fund if you:

1. are covered by the Fund for health benefits at the time you begin to receive a pension benefit immediately after termination of covered employment from the Service Employees 32BJ North Pension Fund (North Pension Fund), and

2. are age 62 or older, and

3. have accrued a minimum of 20 years of service under the North Pension Fund. For the purpose of calculating 20 years of pension service, the number of weeks of severance payments required under a collective bargaining agreement or participation agreement are counted.

If you are eligible for retiree health benefits from the Fund, your dependent spouse is also eligible for retiree benefits if your dependent spouse is covered by the Fund for health benefits at the time you begin to receive a pension benefit immediately after your termination from covered employment from the North Pension Fund.

No other dependents are eligible for retiree health benefits.

Benefits

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Participants and Dependents Under Age 65

If either the participant or dependent spouse is under the age of 65, only prescription drug benefits are available to that individual. The Fund will provide the same prescription drug coverage provided to active Participants through Medco (see the "Prescription Drug Benefits" section), except that the Fund will pay no more than an annual maximum of $1,000 per person. No other benefits are provided.

Participants and Dependents Age 65 and Older

Once a participant or dependent spouse reaches age 65, the Plan will provide a health debit card through WageWorks that can be used to reimburse you for eligible health care expenses, as defined in IRS Publication 502. This is referred to as a Health Reimbursement Account (HRA). The Fund Office will provide you with a list of eligible expenses.

All reimbursements are subject to a cumulative annual maximum of $1,000 per person and $5,000 lifetime maximum per person. The maximum lifetime reimbursement for a participant and a dependent spouse is $5,000 each, whether or not both you and your dependent spouse were active participants in the Fund. The maximum lifetime reimbursement for each participant and dependent spouse under age 65 and over age 65 is cumulative, so that the lifetime maximum reimbursement for each person is $5,000. For example, if you retire at age 62, and you use a total of $1,500 in prescription drug benefits between ages 62 and 65, upon attaining age 65, you will be eligible for a $3,500 benefit on your health debit card.

For any questions regarding the use of your debit card, your benefit balance, recent purchases or eligible expenses, you may call WageWorks toll free at 1-877-924-3967. An automated system is available 24 hours every day and representatives are available to speak with you directly between 8:00 A.M. EST and 8:00 P.M. EST, Monday through Friday, except Federal holidays. You may also visit WageWorks’ website at www.wageworks.com to help answer your questions.

How The HRA Works

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Once you become eligible to participate in the HRA, you will receive a health debit card from WageWorks. You may use this debit card at your doctor’s office, pharmacy or retail store to pay for eligible expenses. Once you have made a purchase on your WageWorks debit card, you must mail a copy of your receipt directly to WageWorks. If you fail to mail your receipt to WageWorks, or if you use your debit card for an expense that is not covered by the HRA, you will be required to repay the amount of the purchase to WageWorks. If you fail to repay this amount, WageWorks will offset future eligible expenses until it recoups the value of the payment. This means that WageWorks will not allow any deductions from your debit card for eligible expenses until the entire cost of an ineligible or undocumented expense has been recovered.

Annual and Lifetime Maximums

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Each year, you will have access to $1,000 on your debit card that you can use at anytime during the plan year. If you exhaust your $1,000 prior to the end of the plan year, you will not have any additional amounts available until the start of the next plan year (assuming you are still within your $5,000 lifetime maximum).

However, you may never spend more than $1,000 in any year, even if you spent less than $1,000 in prior years. Any unused amount at the end of a plan year will be not be available to you, but will become available again after your first five years of participation. For example, participant X enrolls in the HRA program and has available $1,000 in his HRA each year for five years. If participant X spends $1,000 each year, his participation will automatically terminate at the end of the 5th plan year because he has exhausted his $5,000 lifetime maximum. However, if participant X only spent $500 in year one, $1,000 in year two, $750 in year three, $1,000 in year four and $800 in year five, he will have available $950 in year six ($500 + 0 + $250 + 0+ $200), representing his cumulative remaining amount available after his first five years of participation.

Administrative Fees

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If you still have an amount available in your HRA after 60 months of eligibility for the HRA, the Fund will begin deducting a monthly administrative service fee from your account, starting in your 61st month of participation. This amount will be continuously deducted each month until you have no remaining amount available. As of October 1, 2007, the monthly administrative fee is $4.85. This fee is subject to change and you will be notified in writing of any change in the HRA administrative fee.

Termination

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Your retiree health benefits will terminate on the earlier of your death or the exhaustion of your $5,000 lifetime maximum. Your dependent spouse’s retiree health benefits will terminate on the earliest of the following events:

1. your spouse’s death

2. your death

3. your divorce or legal separation from your spouse

4. your spouse’s exhaustion of his/her lifetime maximum

If your spouse’s benefit terminates because of your death, your divorce or your legal separation, your spouse will be eligible to continue his/her retiree benefits under COBRA. Please see the "Continued Group Health Coverage: Under COBRA" section regarding the COBRA rules.