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The summary plan description explains trust-fund administration, eligibility and enrollment timing, life-event rules, COBRA continuation and conversion when employment ends, and guidance for retirement. 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Lynn, Chairman | Frederick Ward |\n| Anthony Calandrino | John Culkin |\n| Brendan McPartland | Howard Fox |\n| Robert Moccio | Jack Larkin |\n| Kevin Cruse | Charles McGinley |\n\n\n| Fund Coordinator | Fund Auditor |\n| --- | --- |\n| Angelo DePietto | Novak Francella LLC |\n\n\n| Fund Counsel | Fund Consultant and Actuary |\n| --- | --- |\n| Barnes, Iaccarino & Shepherd LLP | The Segal Company |\n\nTABLE OF CONTENTS    \nINTRODUCTION 1  \nBenefits Trust Fund 1  \nGroup Legal Services Trust Fund 1  \nELIGIBILITY AND PARTICIPATION 2  \nWho’s Eligible 2  \nWhen Participation Begins 2  \nEnrolling for Coverage 3  \nWhen Coverage Ends 3  \nReinstatement of Coverage 4  \nKeeping the Fund Informed 4  \nLIFE EVENTS AT-A-GLANCE 5  \nIf You Get Married 5  \nIf You Add a Child 5  \nIf You Get Legally Separated or Divorced 5  \nIf You Enter the Uniformed Services 6  \nIf Your Child Loses Eligibility 7  \nIn the Event of Your Death 7  \nIf You Take a Family and Medical Leave 7  \nIf Your Employment Ends: COBRA Continuation Coverage 8  \nIf Your Employment Ends: Converting Your Coverage To Individual Coverage 11  \nWHEN YOU RETIRE 12  \nYOUR HEALTH BENEFITS 13  \nHOW THE PPO MEDICAL PLAN WORKS 14  \nHow Benefits Are Determined 14  \nEMPIRE BLUECROSS BLUESHIELD  \nHOSPITAL CARE 15  \nWhen You Go In-Network 15  \nWhen You Go Out-Of-Network 15  \nEmpire BlueCard® 15  \nPre-certifying Care 16  \nOverview of Eligible Empire BlueCross BlueShield Expenses 17  \nEmergency Care 19  \nInpatient Hospital Care 20  \nAmbulatory Services 20  \nPregnancy and Maternity Care 21  \nSkilled Nursing Facilities 21  \nHospice Care for the Terminally Ill 22  \nHome Health Care 22  \nPhysical Therapy 22  \nOccupational, Speech or Vision Therapy 23  \nOrgan and Tissue Transplants 23  \nMAGNACARE PPO MEDICAL CARE 24  \nWhen You Go In-Network 24  \nSelection of a Primary Care Provider 24  \nDirect Access to Obstetricians and Gynecologists 24  \nWhen You Go Out-Of-Network 25  \nBenefit Maximums 25  \nOverview of Eligible MagnaCare Expenses 26 General Medical Care 29  \nPreventive Care 30  \nDurable Medical Equipment and Supplies 31 What’s Not Covered by the PPO Medical Plan (BCBS  \nHospital and MagnaCare) 31  \nCIGNA OPEN ACCESS PLUS IN-NETWORK COPAY PLAN 34  \nWhen You Go In-Network 34  \nPrior Authorization 34  \nSummary of Benefits 34  \nBenefits 35  \nExclusions 38  \nAdditional Information 39  \nExclusions 40  \nSelection of a Primary Care Provider 42  \nDirect Access to Obstetricians and Gynecologists 42  \nYOUR PRESCRIPTION DRUG BENEFITS 43  \nAt the Pharmacy 43  \nThrough Mail Order 43  \nSpecialty Drug Management Program 44  \nIf You Use an Out-of-Network Pharmacy 44  \nAnnual Maximum Benefit 44  \nEligible Drugs 44  \nIneligible Drugs 45  \nYOUR DENTAL BENEFITS 46  \nTABLE OF CONTENTS continued  \nHOW THE HEALTHPLEX DENTAL PPO PLAN WORKS 47  \nHow Eligible Dental Expenses Are Defined 47  \nHow to Use the Plan 47  \nMaximum Benefits 47  \nPre-treatment Estimate 47  \nSchedule of In-Network (PPO) Copayments and  \nOut-of-Network Dental Allowances 48  \nBenefits When Alternate Procedures Are Available 50  \nDetermining When Treatment Begins 50  \nBenefits After Coverage Ends 50  \nWhat is Not Covered by the Healthplex Dental Plan 51  \nCoordination of Benefits (COB) 51  \nHow to Claim Dental Benefits 51  \nHOW THE AETNA DMO PLAN WORKS 52  \nYour Primary Care Dentist 52  \nOverview of Eligible Aetna DMO Expenses 52  \nBenefits When Alternate Procedures Are","cbCaibUy6hdNbORy","https://ap.wps.com/l/cbCaibUy6hdNbORy","pdf",2571817,104,"English","# INTRODUCTION\n## Benefits Trust Fund\n## Group Legal Services Trust Fund\n# ELIGIBILITY AND PARTICIPATION\n## Who’s Eligible\n## When Participation Begins\n## Enrolling for Coverage\n## When Coverage Ends\n## Reinstatement of Coverage\n## Keeping the Fund Informed\n# LIFE EVENTS AT-A-GLANCE\n## If You Get Married\n## If You Add a Child\n## If You Get Legally Separated or Divorced\n## If You Enter the Uniformed Services\n## If Your Child Loses Eligibility\n## In the Event of Your Death\n## If You Take a Family and Medical Leave\n## If Your Employment Ends: COBRA Continuation Coverage\n## If Your Employment Ends: Converting Your Coverage To Individual Coverage\n# WHEN YOU RETIRE\n# YOUR HEALTH BENEFITS\n## How the PPO Medical Plan Works\n## Empire BlueCross BlueShield Hospital Care\n## MAGNACARE PPO Medical Care\n## CIGNA Open Access Plus In-Network Copay Plan\n# YOUR PRESCRIPTION DRUG BENEFITS\n# YOUR DENTAL BENEFITS\n## How the Healthplex Dental PPO Plan Works\n## How the Aetna DMO Plan Works\n## How the DDS, Inc. Dental PPO Plan Works\n# YOUR OPTICAL BENEFITS\n# YOUR SHORT-TERM DISABILITY BENEFITS\n# YOUR LIFE INSURANCE BENEFITS\n# YOUR ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) INSURANCE BENEFITS\n## How AD&D Benefits Work\n# GROUP LEGAL SERVICES FUND\n## Eligibility\n## How the Plan Works\n# HOW TO CLAIM BENEFITS\n## How to File Claims\n## Claims Denial Notification\n## Appealing a Denied Claim (Non-Hospital Claims)\n## External Review for Claim Denied on Appeal\n# OTHER INFORMATION YOU SHOULD KNOW\n## Coordination of Benefits\n## Subrogation","[{\"question\":\"How are the Benefits Trust Fund and Group Legal Services Trust Fund administered?\",\"answer\":\"They are administered by a joint Board of Trustees consisting of Union Trustees and Employer Trustees with equal voting power.\"},{\"question\":\"When does coverage begin, end, and what happens after it ends?\",\"answer\":\"Coverage begins based on eligibility and participation timing rules, ends according to coverage-ending conditions, and may be reinstated. When employment ends, COBRA continuation coverage or converting coverage to individual coverage may be available.\"},{\"question\":\"What medical plan options are described in the summary plan description?\",\"answer\":\"The document explains how the PPO medical plan works and includes options such as Empire BlueCross BlueShield hospital care, MagnaCare PPO medical care, and the CIGNA Open Access Plus in-network copay plan with outlined in-network and out-of-network rules.\"},{\"question\":\"How do participants claim benefits and appeal a denied claim?\",\"answer\":\"The document defines a claim, explains how to file claims, covers timing for filing, and describes making claim determinations and denial notifications. It also provides the appeal review process for denied claims and external review for certain claim denials.\"}]","International Union of Operating Engineers Local 30 Benefits Trust Fund and Group Legal Services Trust Fund - Your Benefits and Group Legal Services Trust Funds at Work for You Summary Plan Description | PDF",1789634338,36]