About the Plans

National IAM Benefit Trust Fund Medical Plans

The National IAM Benefit Trust Fund offers three medical plans, which are administered by CareFirst Administrators. 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.

Medical Coverage

All Fund medical plans are PPO plans that use the CareFirst Administrators 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 CFA 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.

Medical Services

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 CFA network.

For a list of covered medical services contact the Fund Office.

Medical Summary Plan Descriptions

• 2026 Summary Plan Description (SPD) Plan A and Plan A+
• 2026 Summary Plan Description (SPD) Plan B coming soon
• 2026 Summary Plan Description (SPD) Plan C coming soon
• 2026 Summary Plan Description (SPD) Plan D2 coming soon

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.

CVS Caremark Formulary and Prior Authorization Effective January 1, 2017 (PDF)

Changes to CVS Caremark Formulary and Prior Authorization Effective January 1, 2016 (PDF)

Advanced Control Specialty Formulary Effective January 1, 2016 (PDF)

Legal Spouse Coverage Effective August 13, 2015 (PDF)

Trustee Changes through August 13, 2015 (PDF)

Changes to CVS Caremark Formulary, Generic Step Therapy, and Prior Authorization of Compounds Effective January 1, 2015 (PDF)

Definition of Allied Health Professional Amended Effective October 1, 2014 (PDF)

Dental and Vision Benefits Waiver, Domestic Partnership and Same Sex Marriage dated May 22, 2014 (PDF)

Change to CVS Caremark Formulary and Prior Authorization Requirement for Male Androgens Effective January 1, 2014 (PDF)

Medical Summary of Benefits and Coverage (SBC)

Plan A Summary Benefits and Coverage

Plan A+ Summary Benefits and Coverage

Plan B Summary Benefits and Coverage

Plan C Summary Benefits and Coverage

Plan D2 Summary Benefits and Coverage

Request a Medical ID Card