National IAM Benefit Trust Fund Medical Plans
The National IAM Benefit Trust Fund offers three medical plans, which are administered by CIGNA. Covered employees and their dependents may participate in a Benefit Trust Fund medical plan if it is negotiated into the Collective Bargaining Agreement. All three plans generally pay benefits for the same eligible medical expenses. The primary differences between the plans are the annual deductible amounts, coinsurance (the percentage paid for covered services after the annual deductible is met), and the annual out-of-pocket maximum.
All Fund medical plans are PPO plans that use the CIGNA Open Access Plus (OAP) network. The network consists of more than one million participating providers nationwide. Plan participants have the flexibility to see any doctor or health care provider they choose. However, participants who select OAP network providers will incur the lowest out-of-pocket expenses because the participating providers have agreed to accept pre-negotiated, reduced rates for covered services, and they are paid at the greater in-network benefit percentage.
Benefit Trust Fund medical plans cover an array of medical services. Preventive services, such as annual physical exams and certain routine immunizations, are covered at 100% under all three plans when care is received from an in-network provider. Other medical services are covered at varying benefit levels, depending on service. Before you visit a medical provider, it is always a good idea to double check that the services you are planning to receive are covered by the Benefit Trust Fund medical plan, and that the provider participates in the OAP network.
For a list of covered medical services, view or download sample Schedules of Benefits for the National IAM Benefit Trust Fund medical plans, or contact the Fund Office.
Medical Summary Plan Descriptions
For more detail about how the plans work, including specific information about covered services and benefits, contact the Fund Office to receive a Summary Plan Description (SPD). You can view and download sample medical Summary Plan Descriptions below.
Medical Summary of Material Modifications
Whenever a change is made to a medical plan, the Fund Office will send a Summary of Material Modification (SMM) to explain the change. SMMs should be retained in your Summary Plan Description for future reference. All changes made to a medical plan since the last printing of the Summary Plan Description will be included when the booklet is revised and a new edition of the SPD is issued.
For example, the Fund made changes to its medical plans to comply with the Patient Protection and Affordable Care Act of 2010 (ACA), also known as "Health Care Reform." Such changes include expanding eligible dependent coverage to children up to age 26 and removing lifetime maximum payment limits. You can view and download recent medical Summaries of Material Modifications below.
Medical Summary of Benefits and Coverage (SBC)
Request a Medical ID Card
Participants in a National IAM Benefit Trust Fund medical plan will receive a CIGNA medical ID card in the mail (a separate ID card is provided for the covered employee and each eligible enrolled dependent). Your medical ID card has your member number and important contact information. Present your medical ID card whenever visiting a medical provider.
If you need health care before you receive your ID card, you can log into CIGNA's website and print a temporary ID card. You can also access CIGNA’s website to request a replacement ID card or an additional ID card for any covered participant.