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October 30, 2024

RE: Changes to the Northeast District Council of the OPCMIA Welfare Fund

Click here to see the full summary of the changes.

The following summary describes changes to the Northeast District Council of the OPCMIA Welfare Fund (“Fund”). This summary is intended to satisfy the requirements for issuance of a Summary of Material Modification (“SMM”) under the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). You should take time to read this material carefully and keep it with the copy of the Summary Plan Description (“SPD”) that was previously provided to you. If you need another copy of the SPD, or if you have any questions regarding these changes to the Fund, please contact the Fund Office, either in writing at 1406 Blondell Avenue, 2nd Floor, Bronx, New York 10461 or by telephone at 516-775-2280.

Application of Medical Deductible to Two New Services The Fund offers two medical plans of benefits: Tier I for Journeymen and Tier II for Residential Workers (the “Plans”, each a “Plan”). Each Plan of benefits includes a medical deductible that applies to certain of the Plan’s services. This means that for those services, before Aetna covers the cost of the services, you or your eligible dependent must first satisfy the applicable deductible.

Effective January 1, 2025, the deductible amount will remain the same for each Plan, but the deductible will now apply to the following services:

• Outpatient surgery; and
• Diagnostic outpatient complex imaging (e.g., PET scans, MRIs).

This means that if you receive any of these services beginning in 2025, you must first satisfy the applicable Plan deductible before Aetna will cover the cost of these services.

Click here to see the full summary of the changes.