Dear Participant: We are pleased to present SUP Welfare Plan's Summary Plan Description describing the benefits provided by the SUP Welfare Plan. The Plan was established in accordance with Collective Bargaining Agreements between the Sailors' Union of the Pacific and participating employers.
The Plan Description furnishes a brief description of the benefits to which you and your family are entitled, the rules governing these benefits, and the procedures that should be followed when making a claim. This booklet includes certain information concerning the administration of the Plan as required by the Employee Retirement Income Security Act of 1974. We urge you and your family to read this booklet thoroughly so that you will be familiar with the benefits of the Plan. We are pleased to present this booklet describing the benefits provided by the SUP Welfare Plan.
New Fiscal Year
The new fiscal year starts August 1, 2010 and runs through July 31, 2011. Charges for services incurred on August 1, 2010 and after will be eligible for reimbursement consideration in the new fiscal year. Charges for services incurred prior to August 1, 2010 can only be considered for services in the prior fiscal year even if they are submitted for reimbursement after August 1, 2010.
All services submitted for reimbursement consideration must be submitted to the Plan office within 90 days of the date of services or within 90 days of the processing date of the prime insurance plan.
Reimbursement for Active Participant Co-pays
Kaiser and other HMO Plan member’s co-pays can be submitted to the Plan office by sending a copy of the copayment that indicates the patient name, date of service, and the amount charged the member. PPO Plan members must submit a billing and the PPO Plan explanation of benefits that show how the charge was applied to the plan and the required payment due from the member.
Reimbursement for Vision Care
The vision care benefit for active participants is allowed once in a two year period. The $200.00 maximum includes the exam and glasses. The cost of tints is not included in the reimbursable amount. The vision benefit is for members only and does not include dependents. An itemized bill must be submitted to the Plan office within 90 days of the service. The bill must indicate the patient’s name, date of service, and an itemization of the charges.
The vision care allowance for pensioners is included in the $500.00 maximum of the Pensioners Annual Allowance for medical, dental, and vision co-payments. Glasses are an allowable expense once in a fiscal year.