OPEN ENROLLMENT 2009

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1 Questions? Call OPEN ENROLLMENT 2009 Time Sensitive Material SAVE TIME BY COMPLETING YOUR ENROLLMENT ON-LINE From the Trustees Page 2 Your Plan Choices Page 3 The Enrollment Process Page 4-5 Your Benefits Page 6-7 Required Documents Back Cover Contact Information Back Cover About the Forms Insert

2 Page 2 Central Laborers Welfare Fund WELCOME TO OPEN ENROLLMENT 2009 From Your Central Laborers' Welfare Fund Board Trustees: In these times of economic uncertainty, healthcare coverage is even more important than ever before. The Central Laborers' Welfare Fund Board Trustees are proud of the benefit package they are able to offer eligible Participants and their families. Although the package is not intended to cover all medical expenses or services, it is designed to help reduce out-of-pocket costs associated with the most common medical treatments. If you have questions regarding any of your benefits or need to determine whether procedures and services are covered by your Plan, you are encouraged to contact the Central Laborers' Welfare Fund Office or refer to your Summary Plan of Benefits. Each year, eligible Participants are given the opportunity to choose a network of providers that best meets their needs and the needs of their family. In 2009, all eligible Participants will have two networks to choose from. Retirees on a Central Laborers' Welfare Fund Plan will have two networks to choose from or they may consider enrolling in a fully insured Plan offered through Blue Cross HMO Illinois. Since an enrollment form is required each Plan year, the Central Laborers' Welfare Fund Trustees are pleased to provide an on-line enrollment process that can make that job of completing and submitting information easier. Although paper forms are still accepted, there is a $25.00 gift card that will be issued to each Participant who obtains a NETime Benefit PIN number, enrolls in eletter, and completes their enrollment on-line. Those individuals who already have a PIN number and are taking advantage of the eletter program will only need to complete the on-line enrollment to be eligible for the $25.00 gift card. Instructions for accessing and completing the enrollment process are highlighted on pages 4 and 5 of this brochure. The Central Laborers' Welfare Fund Trustees and staff would like to thank you for the opportunity to assist you and your family. If you have any questions or need help accessing or navigating the Funds web-based programs, you are encouraged to call or to claims@central-laborers. com. Sincerely, Central Laborers Welfare Fund Trustees ADDRESS OFFICE HOURS PO Box 1267 Monday-Thursday: 7:30 AM 5:00 PM 201 North Main Street Friday: 7:30 AM Noon Jacksonville, IL Saturday & Sunday: Closed Phone: (800) Fax: (217)

3 Central Laborers Welfare Fund 2009 PLAN CHOICES Page 3 PPO PLAN If you choose BlueCross BlueShield of Illinois, you will be entitled to nationwide coverage and a large number of in-network physicians and hospitals. This network is excellent for anyone considering a move, who has dependents that live out of state and/ or attending college in another city or state. This Plan also offers more network providers to individuals who travel or work away from home and may require medical care while on the road. By electing this Preferred Provider Organizational (PPO) network, you will make co-payments for most physician exams and the remainder of your in-network claims would be paid at 80% after a $100 annual deductible. There is not a co-pay option for out-of-network claims, they have a high deductible and a lower coinsurance rate. Although BlueCross/BlueShield of Illinois contracts with Carle Foundation Hospital, the Carle Physicians are not in-network. To locate providers in Illinois call: For providers outside Illinois call: (BLUE) Or access their website at: HealthLink Participants find physicians and hospitals throughout the mid-western region including providers in Illinois, Missouri and Indiana. Individuals previously enrolled in the Health Alliance network may find many of their physicians participate with the HealthLink network. Particularly the Carle Physician Group and Carle Foundation Hospital. The HealthLink network is structured on 3-tiers with the HMO level offering the greatest discounts, but no out-of-pocket maximum; the PPO level offering co-payments for most physician exams and a co-insurance for all other services incurred after satisfying a $100 annual deductible; and an out-of-network level with a high deductible and lower co-insurance rate. By choosing HealthLink, you receive benefits under either the HMO or PPO structure depending on your physician s or hospital s contract. To locate providers call: Or access their website at: HMO ILLINOIS (Retiree Plan Only) The HMO Illinois network offers family coverage and an individual retiree coverage plan. Although the HMO Illinois plan provides excellent benefits and is the only retiree option with a single coverage premium, the HMO Illinois plan is not administered by Central Laborers' Welfare Fund and all benefit determinations are made at the HMO Illinois offices. Before choosing this retiree plan option, please consider the following: The HMO Illinois network is only available in a limited area within the state of Illinois. HMO Illinois benefit offering will differ from the Central Laborers' Welfare Fund Plan. Prescription coverage through HMO Illinois is provided through a BlueCross prescription administrator. Before choosing HMO Illinois, please contact the Fund Office to discuss whether this network is the best choice for you. To locate providers call: Or access their website at: BENEFITS If you choose BlueCross/BlueShield of Illinois or HealthLink as your medical network, your benefits through Central Laborers Welfare Fund will include: Medical Coverage, Wellness Benefits, Dental Coverage, Vision Coverage, Hearing Benefits, Prescription Drug Coverage, Death Benefits (Active Participants ONLY), Loss of Time Benefits (Active Participants ONLY) If you choose HMO Illinois (Retiree Only) benefits through Central Laborers Welfare Fund will include: Dental Coverage, Vision Coverage and Hearing Benefits.

4 Page 4 Central Laborers Welfare Fund ON-LINE OPEN ENROLLMENT YOUR STEP-BY-STEP GUIDE 1. Before you will be eligible to receive a $25.00 GIFT CARD, you must make sure you have requested a NETime Benefits PIN number, you have enrolled in eletter, the Central Laborers' electronic communication program, and you have completed your enrollment on-line. 2. Gather all the information you will need to complete the on-line enrollment. Name, address, phone number of your spouses employer Address for any dependent who does not reside with you Copies of all other insurance cards or Medicare cards covering you or any of your dependents. HMO ILLINOIS 3. Review the Network options available to you, which are listed on page 3 of this brochure. Also review the benefit grids enclosed in this enrollment packet which will help you determine the 2009 Plan that is right for you and your family. 4. Log on to the Central Laborers website 5. Click on the Open Enrollment link located on the left side of the Central Laborers home page. 6. Log on to NETime Benefits and follow the links and instructions for completing your Open Enrollment. 7. If you need assistance, please do not hesitate to contact: Central Laborers Welfare Fund at If you have problems while completing the on-line enrollment, you may leave, without submitting and return later after your questions have been answered. 8. Your Open Enrollment period is limited to 30 days. Please allow enough time to receive your NETime Benefits PIN number (usually within 3 business days after you submit a request) and to complete your enrollment on-line (usually requires 15 minutes of on-line time).

5 Central Laborers Welfare Fund Page 5 ON-LINE OPEN ENROLLMENT TO RECEIVE A $25.00 GIFT CARD YOU MUST REQUEST A NETIME BENEFITS PIN, ENROLL IN ELETTER AND COMPLETE YOUR ENROLLMENT ON-LINE. BEGIN HERE 1. GO TO THE CENTRAL LABORERS WEBSITE ON THE LEFT LOWER PORTION OF THE HOME PAGE CLICK ON THE NETIME BENEFITS PIN REQUEST LINK. FOLLOW THE INSTRUCTIONS FOR REQUESTING A PIN NUMBER. 3. AFTER RECEIVING A PIN NUMBER, ENROLL IN ELETTER AND START RECEIVING FUND CORRESPONDENCE VIA COMPLETE YOUR ENROLLMENT ON-LINE USING THE CONVENIENT LINK. ENROLLMENT PROCESS 5. THE OPEN ENROLLMENT LINK WILL TAKE YOU TO THE NETIME BENEFITS PAGE WHERE YOU WILL ENTER YOUR ID AND PIN NUMBER. 6. AFTER ENTERING NETIME BENEFITS, YOU WILL CLICK ON THE 2009 ENROLLMENT LINK AND COMPLETE THE ON-LINE ENROLLMENT.

6 Page 6 Central Laborers Welfare Fund YOUR BENEFITS Medical Benefits Your medical benefits include physician examinations, hospital services, outpatient care, surgical treatment, laboratory and x-ray examinations, durable medical equipment, ambulance transport, therapy, hospice, psychological and substance abuse treatment and much more. Dental Benefits Central Laborers provides you with $1500 in annual Dental Benefits to cover routine dental examinations, periodontal work, major dental work such as crowns, bridges and dentures as well as oral surgery, fillings and root canals. Orthodontic Benefits Your tooth alignment affects more than your smile. It can affect digestion, mouth hygiene, jaw and facial joint function and dental health. That is why Central Laborers has incorporated orthodontic treatment into its Dental Benefit Plan. Orthodontic Benefits are paid at 50% on allowable expenses, are subject to the $1500 annual dental maximum and a $1500 lifetime orthodontic maximum. Prescription Drug Benefits Medication costs are constantly going up. To help offset those costs, Central Laborers offers a 3-tier medication purchasing program. You are offered a Formulary containing a variety of generic and brand name drug options. For your convenience, you can purchase maintenance drugs in a 90-day supply at the pharmacy or through mail-order. In addition, specialty drugs can be purchased through Curascripts. Specialty medications include most injectables and high cost medications. Curascripts not only fills specialty prescriptions, but they provide supervision and educational tools allowing you to better manage your medical condition. Vision Benefits Your eye health is important to Central Laborers. Therefore, the Fund provides you with $300 each year to help cover routine vision examinations, glasses and contact lenses. Hearing Benefits Good hearing is not only helpful in social and family settings, but it is essential to your safety on the job. Central Laborers provides you with hearing benefits to help cover expenses you may incur for routine hearing examinations and for the purchase of a hearing assistance device that may be necessary to improve your hearing and maintain your auditory health. Regarding Vision and Hearing Participants who elect BlueCross/BlueShield of Illinois as their 2009 network may find additional optical or hearing discounts through various participating providers. Check with your provider to see if they offer discounts through the EyeMed Vision program or the TruHearing program. FOR MORE INFORMATION, PLEASE REFER TO YOUR SUMMARY PLAN DESCRIPTION, YOUR 2009 BENEFIT GRIDS OR CALL THE FUND OFFICE AT

7 Central Laborers Welfare Fund YOUR BENEFITS Page 7 WELLNESS BENEFITS Your health is important to you and Central Laborers' Welfare Fund too. That is why your Plan has a Wellness Benefit for you and your family. Eligible Participants and Spouses are provided with $750 annually to apply toward an annual physical examination and all related tests. The first $400 of allowed charges pays at 100%. The remaining $350 covers you at 80% and is not subject to a deductible. Eligible Dependents are allowed $ annually to apply toward physical exams, immunizations and diagnostic tests. The first $200 of allowed charges pays at 100%. The remaining $550 covers at 80% and is not subject to deductible. Dependent exams must be obtained through an in-network provider. WHAT S NEW IN 2009 Most physician exams will not be subject to a deductible and will only require a co-payment. (F0r more details, refer to the Benefit Grids printed on the insert accompanying this brochure.) Mental Health Services are subject to deductible, but will pay at 80% and up to 30 office or outpatient visits per year when received through a BlueCross/BlueShield of Illinois PPO or HealthLink PPO provider. Dental Implants are now covered by the Dental Benefit Plan. These services are subject to the annual dental maximum and all other Plan exclusions. The date of service for the implant and all related care is the date the implant was placed. Routine Adult immunizations are now covered under the Wellness Benefits. These include Hepatitis B, Flu Shots, MMR, Varicella, Tetanus and diphtheria and annual pneumococcal vaccinations. Emergency room physician exams are subject to a $ co-payment and all other emergency services are subject to the annual $ deductible and pay at 80% on all allowed charges. Urgent care physician exams are subject to a $20.00 co-payment. All other urgent care services will be subject to the $ deductible and will pay at 80% on all allowed charges. (PLEASE NOTE BENEFIT CHANGES HIGHLIGHTED ABOVE APPLY ONLY WHEN RECEIVED THROUGH AN IN-NETWORK PROVIDER.)

8 REQUIRED DOCUMENTATION FOR DEPENDENTS SECTION A DEPENDENTS AGE BIRTH TO 19 YEARS OLD Biological Child (Parents Married) Biological Child (Parents Never Married) Biological Child (Parents Divorced) Legally adopted or pending adoption Child placed under legal guardianship Copy of child s birth certificate Copy of child s birth certificate and Voluntary Acknowledgement of Paternity or legal document showing a responsibility to cover the child. Copy of child s birth certificate and the first and last page of the divorce decree, stamped by the court, along with the page showing the custodial parent and who is responsible for the child s insurance coverage. Copy of adoption papers or sworn statement with date of placement. Copy of guardianship papers. Child placed under foster care Step-child Copy of document placing the child in the Participant s home for foster care. Copy of the child s natural parent s first and last page of the divorce decree, stamped by the court, along with the page showing the custodial parent and who is responsible for the child s insurance coverage. SECTION B-DEPENDENTS AGE Unmarried dependent enrolled as a full-time student in an Documents outlined in Section A, a Proof of Dependency accredited educational institution. Form and copy of the current class schedule. Unmarried dependent (handicapped) Spouse Removing ex-spouse, dependent/step-children due to divorce or legal separation. Deleting spouse or dependent coverage due to death Documents outlined in Section A, a Dependent Confirmation Form and statement providing proof of incapacity including the date the handicap began. SECTION C-OTHER CIRCUMSTANCES Copy of marriage certificate and a copy of your spouse s primary insurance card if he/she works full-time and is offered insurance coverage through his/her employer. (See Summary Plan Description for more information on the type of coverage that Full Time working spouses must maintain.) Copy of the first and last page of the divorce decree stamped by the court. Copy of the death certificate. If you have any questions regarding dependent coverage, please call the Fund Office at: ext 120 Federal law requires group health plans to provide medical and surgical benefits for mastectomies, and to pay for the following, when requested by the patient in consultation with their physician: 1. Reconstruction of the breast on which the mastectomy was performed; 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3. Prosthesis and physical complications of all stages of mastectomy including lymphedemas. These services are covered so long as they are performed by a licensed physician and according to Plan provisions. Please Remember! Enrollment information must be returned to the Fund Office or verified online before benefits may be paid in If you or your dependents have other insurance coverage, please send copies of the other insurance cards to the Fund Office in the enclosed envelope. If your spouse works full time and has medical coverage offered through his or her employer, he or she must enroll in the employer s most comparable plan before any medical expenses may be paid by Central Laborers' Welfare Fund. CENTRAL LABORERS WELFARE FUND PO BOX 1267 JACKSONVILLE, ILLINOIS Extensions: Claims Ext 4 Enrollment Ext 120 Dental/Vision Ext 142 Fax: