Retired Employee Eligibility

A.  ELIGIBILITY AT RETIREMENT.

When you retire, you and your eligible Dependents will be eligible for Retired Employee Coverage if:

1.       You are receiving a pension from the Pipe Fitters’ Retirement Fund, Local 597 or a defined benefit pension plan sponsored by Local 597;

2.       You were eligible for Welfare Plan benefits immediately before your retirement and for at least 12 of the preceding 20 benefit quarters; and

3.       You pay the applicable premium for Welfare Plan coverage after the hour run-out of your Accumulated Account.

An Employee who retires, and is eligible for Retired Employee Coverage, and who has sufficient hours in his Accumulation Account to meet the Continued Eligibility Requirements, will be considered a retired employee for purposes of Coordination Benefits.  The benefits for a Retired Employee who has sufficient hours in his Accumulation Account to meet the Continued Eligibility Requirements will be based on the Active Employee Schedule of Benefits for as long as the hours in his Accumulation Account provide eligibility.  Thereafter the benefits for such Retired Employee will be based on the Retired Employee Schedule of Benefits.

Retired Employee Coverage provides different benefits depending on whether the covered individual is eligible for Medicare.  The Schedule of Benefits for Retired Employees not yet eligible for Medicare includes the Death Benefit, the Comprehensive Major Medical Expense Benefit and the Prescription Drug Benefit as well as the Hospice, EAP and Hearing Aid Benefits.

The Schedule of Benefits for Retired Employees eligible for Medicare includes the Death Benefit, the Supplemental Medical Benefit and the Prescription Drug Benefit.  Once you are entitled to Medicare, this Plan will supplement benefits you receive from Medicare Parts A and B.  Therefore, when you and/or your eligible Dependent reach age 65 or otherwise become entitled to Medicare, you MUST apply for Medicare Part A coverage and purchase Medicare Part B coverage.

B.  STANDARD PREMIUMS FOR RETIREE COVERAGE.

Effective January 1, 2005, the self-pay premium for eligible retirees and their dependents who are eligible for Medicare has been set at 9% of the non-subsidized COBRA rate.  For persons not yet eligible for Medicare, the self-pay premium has been set at 15 % of the non-subsidized COBRA rate.  The Standard Premiums that will be charged per person effective January 1, 2006 are as follows:            

If an eligible retiree self-pays for himself and two dependants, no additional self-pay premium is required for the Welfare Fund to cover additional dependents.  Eligibility for Retired Employee Coverage is conditioned on the Retired Employee authorizing any applicable Retiree self-payment or premium to be deducted from the Retired Employee’s monthly benefit received from the Pipe Fitters’ Retirement Fund Local 597.

Each January, the self-pay rate will be adjusted.  The individual rate for a retiree or retiree’s dependent on Medicare will equal 9% of the full self-pay rate charged an active employee on COBRA for that year.  The individual self-pay rate for a retiree or retiree’s dependent not on Medicare will equal 15% of the full self-pay rate charged an active employee on COBRA.

These rates do not apply if you are a Substantially Employed Disability Pensioner as described below.  Also these rates do not apply if you are a pensioner working in the Pipe Fitting industry in non-covered work.  In both cases Higher self-payments are required to continue your medical coverage.  See the Summary Plan Description and the September 2005 Summary of Material Modification for details.

C.  IF YOU RETURN TO WORK AFTER RETIREMENT.

If you are eligible for Retired Employee Coverage and you return to work in Covered Employment, you will continue to be eligible to make self-payments for Retired Employee Coverage until such time as you become eligible for Active Employee Benefits.  You will be eligible for Active Employee Benefits if you satisfy the Initial Eligibility Requirements.  If you become eligible for Active Employee Benefits, such coverage will continue as long as you meet the Plan’s eligibility requirements for Active Employee Benefits.  If your eligibility for Active Employee Benefits ends, you will then resume Retired Employee Coverage.

If you work in the Pipe Fitting Industry in non-covered employment while continuing to receive your pension, you must pay higher premium rates for your retiree medical coverage.  See Summary of Material Modification dated September 2005.

D.  ELIGIBILITY FOR DEPENDENTS OF RETIRED EMPLOYEES.

The rules on Dependent eligibility are the same for Retired Employee Coverage as for Active Employee Benefits.