Glossary of Terms
An eligible person or entity, named by a covered employee, who is eligible to receive benefits (for example, life and accidental death and dismemberment benefits) in the event of the covered employee's death.
The percentage of an eligible expense a participant pays for a covered service, after reaching the deductible.
Employers who have agreed to and contribute to the Benefit Trust Fund to fund participants' health benefits.
The amount your employer contributes to the plan—typically an amount for each hour you work or are paid—to fund your health benefit.
A set amount a participant pays for an eligible expense, usually at the time of service.
Covered employment is generally work in a job classification in an IAM collective bargaining agreement for which contributions are required to be made to the Benefit Trust Fund on your behalf. Covered employment can also include work in some other job classifications if contributions by the employer to the Benefit Trust Fund are required by a written agreement accepted by the Trustees.
A health-related doctor's visit or procedure, provided by a licensed health professional, that a participant in a health plan can receive benefits for.
An annual amount a participant must pay toward the cost of a covered expense until the plan starts paying benefits.
An eligible spouse, partner or child who is covered under a health plan.
A list of brand-name and generic prescription drugs covered under a prescription drug program.
Healthcare providers who have agreed with CIGNA—the administrator of the Fund's medical plans—to recieve discounted fees for covered services.
Healthcare providers who do not have agreements with CIGNA to charge discounted fees for covered services.
The most a participant can pay out of pocket (deductible and coinsurance combined) during a plan year before the plan pays 100% of eligible expenses.
An eligible employee or dependent who is covered under a health plan.
A list of covered services, and the applicable copay or coinsuance amount for each, under a health plan.
A document detailing a change made to a Summary Plan Description (SPD).
A document containing detailed information about a health or welfare plan, including eligibility and claims information, as well as a schedule of benefits.