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Union Local 169 Health Care Plan & Providers

Northern Nevada Laborers Health and Welfare Trust Fund

Summary Plan Description for Active and Retired Employees and Their Eligible Dependents

This Summary Plan Description describes the medical, dental, prescription drug, vision and short term disability, life insurance, and accidental death and dismemberment insurance benefits of the Northern Nevada Laborers Health and Welfare Trust Fund. This is amended, restated and effective January 1, 2017. It covers the benefits for which the Fund pays the claims for you and your eligible dependents.

Asistencia en Español

Asistencia en Español Este documento contiene una breve descripción sobre sus derechos de beneficios del plan, en Ingles. Si usted tiene dificultad en entender este documento, por favor pongase en contacto con la Trust Fund Office teléfono a la 445 Apple Street, Suite 109 Reno, Nevada 89502 y (775) 826-7200 a la dirección y en el Quick Reference Chart de este document.

About the 2018-2019 Preferred Provider Directory

We are very pleased to have added new providers to your Preferred Provider Directory. With preferred providers available, you can now save yourself and your Trust Fund money by selecting preferred providers whenever you need medical, dental or vision care.

REMEMBER – Your Network is in a constant state of change. New Providers may enter the Network. Currently listed providers may no longer participate. Before services are rendered, please verify Preferred Provider status by calling the Healthcare Services Department at your Trust Fund Office, (775) 826-7200. Before making an appointment with a provider you have not seen before or to verify that a current PPO contract is in effect. It is your responsibility to verify that your choice of provider and/or location of office/facility are in fact a Preferred Provider. Failure to do so may result in reduced benefits and higher out-of-pocket expense to you.

Just because a specialist is listed in your Directory, does not mean that all services provided are covered benefits. READ YOUR SUMMARY PLAN DESCRIPTION CAREFULLY. If you do not understand it or are uncertain if a service is a covered benefit, call the Trust Fund Office for assistance.

Questions?

If you have questions about your benefits, contact the Trust Fund Office at 445 Apple Street, Suite 109 Reno, Nevada 89502 or (775) 826-7200.

You should understand, however, that only the full Board of Trustees is authorized to interpret the benefits described in this booklet and that this authority cannot be delegated to Trust Fund Office staff. In addition, no employer or union, or any representative of any employer or union, is authorized to interpret this Plan on behalf of the Board of Trustees or act as an agent of the Board of Trustees.