SUPPLEMENTAL HEALTH REIMBURSMENT ACCOUNT PLAN (HRA) effective July 1, 2021

ELIGIBILITY

Initial and Continuing Eligibility
An Employee is eligible for participation in the HRA on the first day of the month when an HRA is established for him. An HRA is established for an Employee when his Dollar Bank Account has more than a twelve (12) month reserve for health care premiums. Any Employer Contributions in excess of a twelve (12) month reserve in an Employee’s Dollar Bank Account will be permanently transferred to an HRA Account for the Employee. You will continue to participate in the HRA as long as funds remain in your HRA Account. There is NO LIMIT on the amount of Employer Contributions that can be held in the Participant’s HRA Account.

Example: The current health premium is $1,287 per month. Your Dollar Bank balance must be more than $15,444 for the establishment of an HRA account. On 01/31/2024, Member A has a Dollar Bank balance of $16,444. He will have $1,000 transferred to an HRA account on 02/01/2024. On 01/31/2024, Member B has a Dollar Bank balance of $5,744. He will not have an HRA account until his Dollar Bank balance is more than $15,444.

HRA BENEFITS
A Participant may receive reimbursement for Covered Expenses up to an aggregate allowance of $15,000 in a Plan Year. For services covered under the Health, Dental and Vision Plan documents, Covered Expenses for the purposes of this Plan include only the following:

ALL PARTICIPANTS
(1) Medical, dental and vision Deductibles, Co-pays and/or Co-insurance;
(2) Prescription Drug costs not covered by another Insurance Carrier Policy;

(3) DENTAL expenses not covered by another Insurance Carrier policy:
            ◦ Dental X‐Rays
            ◦ Dentures, Bridges and Crowns
            ◦ Exams and Teeth Cleaning (once every 6 months)
            ◦ Extractions, Root Canals and Fillings
            ◦ Oral Surgery
            ◦ Orthodontia for dependent children (once per lifetime)
            ◦ Periodontal Services

(4) Vision expenses not covered by another Insurance Carrier policy:
            ◦ Eye Exam (every per calendar year)
            ◦ Eyeglasses-Frames and Lens (every per calendar year)     
            ◦ Laser Eye Surgeries
            ◦ Prescription Safety Eyewear (every per calendar year)
            ◦ Contact Lens (12 month supply per calendar year)

(5)  Hearing Aid expenses not covered by another Insurance Carrier policy:

• Hearing Aid(s) (every three years)
• Hearing Aid(s) Repairs

This benefit does not cover any of the following:

• Office Visits with an Audiologist
• Diagnostic or Routine Hearing Exams
• Replacement Batteries
• Hearing Aids Provided for Cosmetic Purposes

FOR RETIREES AND SEPAPARATED EMPLOYEES ONLY:
(6) Medicare supplement premiums;
(7) COBRA premiums; and,
(8) Individual or family fully insured health insurance premiums.

The following Covered Expenses will not be reimbursed:
Expenses incurred more than one (1) calendar year from date of service;
Expenses covered by any other plan of benefits; or,
Expenses incurred before the HRA Plan or your HRA Account was established.

We have retained the services of BPAS to administer the HRA.
BPAS contact information:

Customer Service– 866-401-5272
Website: U.BPAS.COM
Mobile APP: BPASClaims
Claims Fax#: 866-254-2942

Claims Mailing Address:
820 Gessner Rd, Ste 1250
Houston, TX 77024

Please review the HRA Guide on how to file claims for reimbursement, check your HRA balance, view claim history and contact information.

2024 Health, Dental and Vision insurance Information

The health & welfare rate for 2024 is $7.96 per hour.

The Health insurance premium is  $1287.00 per month.

Dental and Vision coverage is an added benefit of the plan.

Health Coverage is provided by Blue Cross Blue Shield of Alabama. 1-800-292-8868  www.bcbsal.com

Dental Coverage is provided by Guardian. 1-800-541-7846    www.guardiananytime.com

Vision Coverage is provided by VSP.  1-800-877-7195   www.vsp.com

HRA Coverage is provided by BPAS.  1-866-401-5272  www.u.bpas.com

Blue Cross Blue Shield of Alabama health insurance- There are no changes to copays or deductibles for 2024. All benefits remain the same. Please refer to the BCBS Benefit booklet for complete coverage details. Contact Blue Cross Blue Shield of Alabama at 1-800-292-8868 or online at www.bcbsal.com. Many services are available on the website; view and file claims, find a doctor, manage prescriptions, compare drug costs and find a pharmacy. Blue Cross now offers an APP for mobile devices that includes many of the online services.

EXPLANATION OF THE HEALTH & WELFARE DOLLAR BANK SYSTEM AND HOW HOURS ARE REPORTED.

A “Dollar Bank” will be established to accumulate Employer contributions credited to each Participant in excess of the initial and continuing eligibility requirements up to a maximum reserve of twelve (12) months.  Dollar Bank contributions will be used toward future eligibility when needed.  Monthly Insurance Premiums will be deducted from your Dollar Bank and remitted to the appropriate Insurance Carrier.

When Employer contributions in excess of the minimum requirements for initial and continuing eligibility are received, all contributions in excess of the minimum requirements will be credited to your Dour Bank up to a maximum reserve of twelve (12) months.  Employer contributions in excess of twelve (12) months will be permanently transferred to a Participant’s HRA Account.

The Plumbers & Steamfitters Local Union 52 Health & Welfare Plan was created to provide health, dental, vision, death and disability coverage to Employees. While the Plan provides a Dollar Bank to be used by Participants and Employees during times when work is slow or not available, the Dollar Bank is not a vested benefit and use of it is limited to Eligible Employees as provided in the Plan’s governing documents.  Under the terms of the Plan, an Employee is an individual who is employed by or seeking employment with an Employer to render services which under the terms of a collective bargaining agreement or other agreement require the Employer to make contributions to this Plan.  Upon meeting these guidelines, you are eligible for coverage.           

However, should it be determined, that you are no longer employed or seeking employment with an Employer who contributes to the Plan, you are not an Employee or Participant.  As such, you would no longer have access to a Dollar Bank to continue coverage under the Plan.    Without the Dollar Bank, you would not have sufficient hours for participation in the Health, Dental and Vision Plan.  At that time, your coverage under the Plan would terminate and you would receive Notice of Continuation Coverage under COBRA.  Any remaining Dollar Bank balance will be forfeited to the Plan.  You will also forfeit your HRA Account if you are no longer an Employee, Separated Employee, Retiree or no longer work under a collective bargaining agreement with any AFL-CIO affiliated labor organization.

Dollar Bank and Health Premiums effective January 1, 2024 -  The health & welfare benefit rate of $7.96 per hour is based on working 162 hours each month to cover the health premium of $1287.00.  Premiums are deducted from your dollar bank on the 1^st of each month for the following month (ex: on 01/01/24, premium for 02/01/24 is deducted.  Local Contractors are required to remit hours to the Plan by the 15^th of the month following the work month (ex: January work hours will be received in February).  Premium notices are mailed around the 15^th of each month if your dollar bank is depleted. If you receive a premium notice, please do not disregard it…you are receiving the notice because 1) you have been out of work and your dollar bank is depleted or 2)  you are working out of town and your hours have not been received.  Please call the Benefit Office immediately so we can contact the Contractor or Local to locate your hours.  Please note that your health & welfare dollar bank insurance coverage is based on hours received…not hours worked.  Therefore, if you are working out of another Local, have not worked enough hours or hours have not been received by the plan… and you receive a premium notice, you must pay the premium for your health insurance coverage to continue.

When working through another Local, it normally 2-3 months, sometimes longer, for the Plan to begin receiving hours worked.  The health & welfare rate per hour is different for each Local. Therefore, based on that rate you may need to work more/less hours to cover the premium each month.  If the rate for that Local is less, then you would need to work more hours to cover the monthly premium.  This lower rate could cause a reduction in your hour bank balance and over time may cause you to owe premium out of your pocket.  If the rate for the Local is more, then you would need less hours to cover the monthly premium and this should help increase your dollar bank balance.

Please read the Summary Plan Description for complete details.  

Legal Notices are available under the Documents/Health & Welfare section.

Privacy Notice, Grandfathered Status, Electronic Benefit Booklets, Womens Health & Cancer Rights Act, Rights Under Newborns & Mothers Health Protection Act, Creditable Drug Coverage, MarketPlace, COBRA, Premium Assistance under Medicaid and CHIP, Local 52 Hour bank system.

H&W Legal Notices