MESSAGE FROM THE TRUSTEES - DC 37: New York …

1 MESSAGE FROM THE TRUSTEESDear Member:We are pleased to present you with this booklet, also called a Summary Plan Description, whichsummarizes the benefits provided by the District Council 37 Health & Security Plan (the Plan ) and the DistrictCouncil 37 Education Fund. This booklet also explains how to determine whether you are eligible for benefitsand how to submit claims in order to receive benefits. In addition, it provides you with an explanation of yourrights and responsibilities. The primary purpose of this booklet is to provide you with a non-technical explanation of the mostimportant features of the benefits. It is not a substitute for the official Plan documents that set forth the detailsof the benefits provided by the Plan.

2 Accordingly, this Summary Plan Description does not change or otherwiseinterpret the terms of the official Plan documents, such as the trust agreement under which the Plan isestablished, and agreements with providers of benefits under the Plan s trust agreement. Your rights can bedetermined only by referring to the full text of these official documents, which are available for your inspectionat the Plan Office. Please note also that no one (other than the Board of TRUSTEES ) has the authority to interpretthe Plan (or official Plan documents) or to make any promises to you about Summary Plan Description has no legal force or effect -- only the formal Plan documents themselvesactually govern the operation of the Plan and the benefits to which you (and/or, if applicable, your dependents)may be entitled.

3 This booklet is supplied solely for the purpose of assisting you in comprehending the scopeand meaning of the Plan, and is not intended to interpret, replace, or amend the Plan. To the extent that any ofthe information contained in this booklet is inconsistent with the official Plan documents, those documents willgovern in all particular attention is directed to the various deadlines for filing claim forms in order to obtainbenefits. These deadlines, which are strictly applied, are set forth on page 32 and also call to your attention that the TRUSTEES have the authority, in their sole and absolute discretion,to amend, modify or terminate the Plan at any time, and the sole and absolute discretion to interpret the Planprovisions and all official Plan documents.

4 Please see page 51 for more information concerning this hope that you will review this booklet carefully and share it with the members of your family, sincemany of the benefits described are also available to your eligible dependents. Familiarity with what is availableto you under the Plan will help to ensure that you make the best possible use of the benefits to which you reading this booklet, if you have questions concerning the benefits to which you are entitled, please feelfree to contact the Health & Security Plan s Inquiry Unit telephone number, (212) 815-1234, the Municipal EmployeesLegal Services telephone number, (212) 815-1111 or the Education Fund s telephone number, (212) Whitman DC37 F-T Book 3/7/08 3:14 PM Page 3 Please note that some of the benefits provided hereunder, such as Legal Services, may besubjected to income tax.

5 You should consult with your income tax advisor if you have any questions withrespect to the taxation of such benefit as the TRUSTEES make no representations as to the taxconsequences to you of your Plan addition to providing a plan of benefits which is responsive to your needs, the TRUSTEES continuallyevaluate and explore new ways of providing benefits and services. Our goal is to see that our members receivebenefits of the broadest nature possible and that the services delivered are both cost effective and high hope this booklet will assist you in understanding these benefits and that through your assistance as aninformed consumer the excellent package of benefits offered will be viable into the Solidarity,District Council 37 Benefits Fund TrustLillian RobertsOliver GrayMaf Misbah UddinChairTrusteeSecretary-TreasurerDate d: January 200876451-2 Whitman DC37 F-T Book 3/7/08 3:14 PM Page 4 TABLE OF CONTENTS1.

6 Who is Eligible For These Benefits.. 1 Part IHealth & Security Plan Benefits1. Dental Benefit.. 72. Vision Care Benefit.. 123. Prescription Drug Benefit .. 134. Disability Benefit .. 175. Catastrophic Medical Benefit.. 196. Second Surgical Consultation Benefit .. 197. Death Benefit .. 208. Accidental Death and Dismemberment Benefit .. 219. Podiatry Benefit .. 2210. Audiology Benefit .. 2311. Help from the Personal Services Unit .. 2412. Help from the Health and Pension Services Unit.. 2613. Survivor Benefit .. 2614. COBRA Benefit .. 2715. Privacy of Protected Health Information .. 3016. How to Obtain Benefits .. 3217. Coordination of Benefits .. 3318. Legal Services Benefit .. 35 Part IIEducation Fund Benefits1. Education Fund.

7 412. Education Fund Programs and Services .. 41 Part IIIG eneral Information For All Funds1. If a Benefit is Denied .. 462. General Information With Respect to Plan Administration .. 503. Defrauding the Plan(s) .. 524. Your Rights .. 525. Titles Eligible For Benefits .. 546. Notice of Privacy Practices .. 5576451-2 Whitman DC37 F-T Book 3/7/08 3:14 PM Page 576451-2 Whitman DC37 F-T Book 3/7/08 3:14 PM Page 6 WHO IS ELIGIBLE FOR THESE BENEFITS?As a member of a collective bargaining unit represented by DC 37, you are eligible for the benefits described inthis booklet if you: are a full-time per annum or full-time per diem employee1; or an Assistant City HighwayRepairer, working in a Covered Job Title2represented by DC 37; are employed by the City or State of new york ,a Related Agency such as the TA, TBTA or certain Cultural Institutions3; and a contribution is made or due onyour are a per annum employee if your salary is figured and paid on a yearly basis, rather than on an hourly, dailyor per session basis.

8 You are covered if you work in a job title described in Titles Eligible for Benefits and areemployed by one of the following:Brooklyn Public LibraryCity of new york (Mayoral Agencies)City University of New YorkEducational Opportunity CentersOffice of Court AdministrationNew york City Department of EducationNew york City Health & Hospitals CorporationNew york City Housing AuthorityNew york City Off-Track Betting CorporationNew york City School Construction AuthorityNew york City Transit AuthorityNew york State Rent Regulations Services UnitQueensborough Public LibraryTriborough Bridge and Tunnel AuthorityNew employees working in Covered Job Titles become eligible for these benefits on the first day of employmentin a covered job title for which the employer has contracted to make a contribution.

9 Your eligibility ends when you are no longer an active employee. That is, when you are no longer on the payrollin one of the Agencies listed above, in a Covered Job course, there are some acts of misconduct, which may result in the limitation or deprivation of benefitsotherwise available under these Plans. Should a situation of this nature arise, you will be advised of that factand be given an opportunity to respond. See page 52 (Defrauding the Plan).If, after becoming eligible, you are laid off, no longer an active employee or otherwise terminated, and are rehiredin a covered job title, your eligibility for Health & Security Plan coverage will resume as soon as you have workeda full full-time per diem employee is one who works the appropriate number of hours (no less that 35 hours per week for the equivalent per annum title) forat least 18 continuous months, immediately preceding the beginning of said quarter and continues to meet the above mentioned criteria.

10 If you meetthese conditions you will be entitled to receive full-time welfare fund benefits. This currently applies to Mayoralty and Department of Education ClericalAdministrative Covered Job Title is a title described in the section entitled TITLES ELIGIBLE FOR BENEFITS .3 Cultural Institutions which are currently required to make and are making a contribution to the DC 37 Benefits Fund Trust. At present the Brooklyn Publicand Queensborough Public Libraries meet the requirement. Employees of other Cultural Institutions or those employees represented by Local 371,Local 768, or Local 375 may be required to obtain all or some of their benefits from other plans. If you have any question with regard to your eligibility,under this or any other plan, please call (212) 815-1234 for Whitman DC37 F-T Book 3/7/08 3:14 PM Page 1 Eligibility for all benefits stops when you are no longer on the payroll, are placed in an inactive leave status, laidoff or moved into a job title not covered by the Plan.