Pipe Fitters' Welfare Fund, Local 597 (Retiree Plan Highlights)

Retirees Not Working in the Industry
Rates Effective January 1, 2010

Retiree not on Medicare, no dependents	$146 per month
Retiree not on Medicare, with dependent not on Medicare	$292 per month
Retiree not on Medicare, with two or more dependents not on Medicare	$438 per month
Retiree not on Medicare, with dependent on Medicare	$234 per month
Retiree not on Medicare, with dependent on Medicare and one or more dependents not on Medicare	$380 per month
Retiree not on Medicare, with two dependents on Medicare	$322 per month
Retiree on Medicare, no dependents	$88 per month
Retiree on Medicare, with dependent on Medicare	$176 per month
Retiree on Medicare, with dependent not on Medicare	$234 per month
Retiree on Medicare, with two or more dependents not on Medicare	$380 per month
Retiree on Medicare, with dependent on Medicare and one or more dependents not on Medicare	$322 per month
Retiree on Medicare, with two dependents on Medicare	$264 per month

Retiree Working in the Industry
Rates Effective January 1, 2010

Retiree not on Medicare, no dependents, running out hour bank	$146 per month
Retiree not on Medicare, with one or more dependents not on Medicare, running out hour bank	$292 per month
Retiree not on Medicare, no dependents, after hour bank run out	$292 per month
Retiree not on Medicare, with one or more dependents not on Medicare, after hour bank run out	$584 per month
Retiree not on Medicare, with one or more dependents on Medicare, running out hour bank	$234 per month
Retiree not on Medicare, with one or more dependents on Medicare, after hour bank run out	$468 per month
Retiree on Medicare, no dependents, running our hour bank	$88 per month
Retiree on Medicare, no dependents, after hour bank run out	$176 per month
Retiree on Medicare, with one or more dependents not on Medicare, running out hour bank	$234 per month
Retiree on Medicare, with one or more dependents not on Medicare, after hour bank run out	$468 per month
Retiree on Medicare, with one or more dependents on Medicare, running out hour bank	$176 per month
Retiree on Medicare, with one or more dependents on Medicare, after hour bank run out	$352 per month

Disability Retiree with Earnings above $24,000
Rates Effective January 1, 2010

Disability Retirees under age 60 with Annual Social Security wages in excess of $24,000 in the year will pay higher rates in the following year.

Retiree not on Medicare, no dependents	$243 per month
Retiree not on Medicare, with one dependent	$486 per month
Retiree not on Medicare, with two or more dependents	$729 per month

Death Benefits

Benefit	Benefit Amount or Limitation
*Death Benefit for Retired Employee Only*	*$5,000*

For additional information regarding Death Benefits and Accidental Death and Dismemberment Benefits refer to the Summary Plan Description (SPD) Section 4.

Comprehensive Medical Expense Benefits - Not Yet Eligible for Medicare

Benefit

Benefit Amount or Limitation

Medical Expense Benefits

Calendar Year Deductible

$300 per person - $900 Family

Maximum Benefit

Maximum per Sickness
or Accident

$2,000,000 per Person

Spinal Manipulation Maximum
(including diagnostic tests)

$1,500 per Calendar Year
(for covered individuals age 16 and older)

Covered Expenses Payable by the Fund up to the Usual and Customary Fees

PPO Charges

Non PPO Charges

Physician, Hospital/Facility
(inpatient and outpatient)

85%

75%

Skilled Nursing Care

60 days per confinement;
See Sec. 7.08 (A) (10)

Out-of-Pocket Maximum per Calendar Year

$1,000 per Person for
PPO expenses
$2,500 per Person for
Non-PPO expenses

Out-of-Pocket Maximum Does Not Include:

· Deductible Amount

· Prescription Drug
Co-payments

· Dental Expense Payments

· Vision Care Expense
Payments

· Co-payments for Outpatient Treatment of Mental and Nervous Disorders or Chemical Dependency

Once you reach the Out-of-Pocket Maximum, the Plan pays 100% of allowable expenses for the calendar year up to the Maximum Benefit listed above. Expenses that apply towards the Non-PPO out-of-pocket limits apply towards the PPO out-of-pocket limits and vice versa.

Note: Durable Medical Equipment and Local Ambulance Service for which PPO services are not available will be covered the same as PPO charges

Mental and Nervous Disorders

PPO Charges

Non PPO Charges

Outpatient

50%

Inpatient

85%

75%

Chemical Dependency

PPO Charges

Non PPO Charges

Outpatient

50%

Inpatient

85%

75%

Inpatient

$6,000 per Course of Treatment
Limited to Two Courses of Treatment per Lifetime

Outpatient Physical/Speech Therapy Maximum

$3,500 per Calendar Year*

Outpatient Occupational Therapy Maximum

$3,500 per Calendar Year*

* After the $3,500 outpatient maximum is reached, no other payment is made under the Plan with the following exceptions: if $3,500 is reached for the outpatient treatment of cerebral palsy, cerebral vascular incident (stroke), intracranial bleed, other head traumas, spinal cord injuries, multiple or complicated fractures or other catastrophic diagnoses with neurological implications, then the Fund pays 75% and the Participant co-pay is 25%.

For additional information regarding Comprehensive Medical Expense Benefits - Not Yet Eligible for Medicare refer to the Summary Plan Description (SPD) Section 7.

Employee Assistance Plan

Benefit	Benefit Amount or Limitation
*Employee Assistance Plan (EAP) for Retired Employees and Dependents*
Initial Counseling with EAP Staff	Up to Three Sessions Covered at No Charge

For additional information regarding Employee Assistance Plan refer to the Summary Plan Description (SPD) Section 12.

Hearing Aid Benefits

Benefit	Benefit Amount or Limitation
*Hearing Aid Benefit for Retired Employee and Dependents*
Hearing Aid and Exam	100% Up to $900 per Ear
Frequency Limit	One per ear for any 36 consecutive month period

For additional information regarding Hearing Aid Benefits refer to the Summary Plan Description (SPD) Section 14.

Prescription Drug Benefits

Benefit	Benefit Amount or Limitation
*Prescription Drug Benefit for Retired Employee and Dependents*
Co-Pay Percentage (if greater than minimum co-pay amounts)	20%
Minimum Co-Pay Amount	Retail (34 day supply)	Mail (90 day supply)
Generic	$5	$10
Brand Preferred	$15	$30
Brand Non-Preferred	$30	$60
Specialty Drug Co-Pay Percentage	20%
Annual Out-of-Pocket Maximum for Specialty and Prescription Drugs (Excludes Prescription Narcotics (narcotic agonists)	$5,000
The participant co-payment for prescription narcotics (narcotic agonists) is always 20% and is not subject to any Out-of-Pocket Maximum

For additional information regarding Prescription Drug Benefits refer to the Summary Plan Description (SPD) Section 9.

Dental Care Discounts

If you are eligible for Retired Employee Coverage, you now have access to the discounts under a dental PPO network. The Fund does not pay for the services provided by your Dentist. However, the Fund pays a fee so that you will have access to discounts under the dental PPO network. The retiree pays the full cost of the discounted dental services directly to the provider.

For additional information regarding Dental Care Discounts contact Dental Network of America (DNOA) at 1-800-367-1203

Medicare Supplemental Medical Expense Benefits

*Supplemental Medical Expense Benefit*	Amount Paid by Medicare in 2010	Amount Paid by Participant in 2010	Amount Paid by Plan in 2010
Amounts Payable During any Hospital Confinement
First 60 Days	Amount over $1,100	$448	$652
61^st Day Through 90^th Day	Amounts over $275 per Day	$37 per Day	$238 per Day
91^st Day Until End of Lifetime Reserve	Amounts over $550 per Day	$74 per Day	$476 per Day
After Lifetime Reserve is Exhausted	0%	20%	80%
Pints of Blood
First Three Pints			$25 per pint
More than Three Pints	100%	0%	0%
Medicare Part B Deductible	0%	0%	100%
Medicare Part B Expenses After Deductible	80%	0%	20%
Medicare Part B (Mental Health)	50%	30%	20%
*Skilled Nursing Facility*
First 20 Days	100%	0%	0%
21^st Day Through 100^th Day	Amounts over $137.50 per Day	$18.50 per Day	$119 per Day
Maximum payable by the Plan per Sickness or Accident	*$2,000,000*

For additional information regarding Medicare Supplement Medical Expense Benefits refer to the Summary Plan Description (SPD) Section 8.

Wellness Benefit

Covers Routine Physical Exams and Weight Watchers®.

The Plan provides for a Wellness Benefit that consists of a Routine Physical Exam Benefit and a Weight-Loss Program.

Routine Physical Exam Benefit.
The Routine Physical Exam Benefit applies to active and retired employees and their dependent spouses, except persons with Retired Employee coverage who are Medicare eligible. Persons with Retired Employee coverage who are Medicare eligible are already covered by most of these services and lab tests through Medicare and the Fund’s Supplement to Medicare.

Under the Routine Physical Exam Benefit, the Fund will pay the full Usual and Customary Fee for the covered service. If you go to an out-of-network provider, this amount may be substantially less than the amount charged by your provider. Under the Routine Physical Exam Benefit you can receive the following services once per calendar year:

Routine physical examination by a licensed M.D. or D.O.

Wellness laboratory tests as follows:

Comprehensive metabolic panel (organ function)

Lipid panel and total cholesterol

Occult blood over age 35 (gastrointestinal)

Complete blood count with differential WBC (diseases)

Complete urinalysis (infections, diseases)

Blood glucose (diabetes)

PSA screen (prostrate) for men over 40 and Mammogram for women over 40.

No deductible or co-payments will need to be paid for the above services. Any other medically necessary tests and services ordered by the physician are covered under the Comprehensive Major Medical benefit and subject to deductible and co-payments.

To take full advantage of the Wellness Benefit, download the postcard and present it at your Doctor’s office when scheduling or undergoing the exam.

Weight-Loss Program
Pipe Fitters has joined forces with Weight Watchers® to bring you convenient weight-loss solutions from the only commercial weight-loss plan with evidence it works!

The Fund pays for the full cost of the 13 weeks program or will apply that amount towards whatever option you select, including Weight Watchers Online or Weight Watchers At Home. The benefit pays once per lifetime per employee per spouse.

The Choice is Yours!
Weight Watchers Local Meeting vouchers:
Local Meeting vouchers are a 13 weeks prepaid program that offers the flexibility of attending Weight Watchers meeting in your community when and where it suits you best.

Weight Watchers Online subscription:
With Online subscription you can follow Weight Watchers step-by-step online, with interactive tools and resources. Weight Watcher messages sent directly to your email address, hundreds of recipes and meal ideas.

Weight Watchers At Home kit:
The At Home kit gives you information and resources by mail to follow the plan step-by-step at home. The kit includes weight-loss tools and bonus products that are conveniently delivered to your home, along with access to a Toll-free Helpline with 26 weeks of progress reporting.

Call 1.866.204.1141 to start a program today or go online to Weight Watchers® .

Benefit	Benefit Amount or Limitation
*Wellness Benefit for Retired Employee and Spouse Not Yet Eligible for Medicare*
Physical Exam (and specified lab tests)	100% - PPO Only
Weight Watchers	13 Week Session

For additional information regarding Wellness Benefits refer to the Summary Plan Description (SPD) Section 13.

Weight Watchers
Weight-Loss Program

Pipe Fitters has joined forces with Weight Watchers® to bring you convenient weight-loss solutions from the only commercial weight-loss plan with evidence it works!

Call 1.866.204.1141 to start a program today or go online to Weight Watchers® .

Benefit	Benefit Amount or Limitation
Weight Watchers	13 Week Session

For additional information regarding Weight Watchers Benefits refer to the Summary Plan Description (SPD) Section 13.

Health Reimbursement Arrangement (HRA)

If you are receiving a monthly pension benefit from the Pipe Fitters' Retirement Fund, Local 597 and you: (1) are eligible for Retired Employee Coverage under the Plan or (2) were previously an Employee eligible for benefits under this Plan, the Trustees have created an HRA account for you for the reimbursement of certain medical expenses you incur.

For additional information regarding Health Reimbursement Arrangement (HRA) refer to the Summary Plan Description (SPD) Section 3.

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Pipe Fitters' Welfare Fund, Local 597 Plan Highlights for Retired Employees

Pipe Fitters' Welfare Fund, Local 597
Plan Highlights for Retired Employees