Locals103318649841

March 2017

Mid CentralOperating Engineers

Health & Welfare Fund

What’s inside...

• Getting fit may be easier than you think

• Self-Payment Rates for Retirees

• Amendment Number 2

• Summary of Annual Report

Dear Participant: March 2017

Within this notice, you are provided with important information related to your benefits. Mid Central Operating Engineers Health and Welfare Fund strives to keep our participants informed when it comes to their benefits.

• Retiree Rates• Amendment 2• Summary Annual Report

We encourage you to visit www.midcentral.org for important announcements related to the Fund and your benefits. With a simple click of the mouse you can access eligibility, view work hours paid on your behalf, check the status of your health claim, access forms and much more.

Sincerely,

Board of Trustees

Important Note: All retiree rates effective April 1, 2017, however if you prepay your benefits monthly or you are participating in the monthly ACH (automatic deduction) please contact the Fund office for the month this increase will affect you, since monthly payments increase prior to April.

First, make time for exercise.If you’re busy, don’t let it stop you. Just fit more activity into the things you already do every day – whether at home or at the office:

}} Take the stairs. You’ll get a workout and avoid that crammed office elevator. For a more strenuous workout, go up and down the stairs for 15 minutes.

}} Park farther away. Running errands, at work or dropping off kids,

park as far away as you can to add a few steps into your day.

Before you know it, you’ll find you do have time to be active. Doctors recommend at least 30 minutes of moderate activity five or more times a week. So, if you take that brisk walk to and from your car every day, you’re well on your way to getting enough exercise.

Second, do what you love.Maybe you love playing tennis, rolling around in the yard with your kids or perfecting your garden. When you enjoy exercise, you’re more likely to keep it up. Check out the estimated calories burned for someone between 130-190 pounds in an hour:

}} Playing billiards 148-216

}} Bowling 177-259

}} Cleaning the house 207-302

}} Cooking/preparing food 148-216

}} Dancing 266-388

}} Playing darts 148-216

}} Fishing 236-345

}} Playing Frisbee 177-259

}} Golfing 236-345

}} Mowing the lawn 325-474

}} Pushing stroller with child 148-216

}} Playing Ping-Pong 236-345

Lastly, get help from friends.Everything is easier with help. If you know someone who’s already active, ask for tips and support. Or you could ask to join them for a workout.

Getting fit may be easier than you think.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue Shield of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

SourcesCenters for Disease Control and Prevention & Cooper Institute for Aerobics Research. Personal energy plan-physical activity: steps for adding PEP to your life. Dallas: Cooper Institute; 1999.

This information is intended for educational purposes only, and should not be interpreted as medical advice. Please consult your physician for advice about changes that may affect your health.

03998MUMENABS 12/14

Set small, but clear goals.If you’re jogging, start with a half mile. The next week, try a full mile. Before you know it, you’ll be able to run a long distance. And if you have some setbacks, that’s okay. In the end, you’ll see success.

Track your progress.Using a fitness tracker helps you measure things like steps walked and calories burned. This data helps you measure your success and stay motivated.

Think long-term.Doctors say it’s best to do 30 minutes of moderate activity, like gardening or walking, at least five times a week. If that sounds like a lot, build on small goals month by month. What else is the key to success? Stay patient and positive until you get there – and you will get there.

Self-Payment Rates for Retirees with Retirement dates Prior to December 1, 2007Effective 4/1/17

Years Single Single Married or 1 dependent

Married or 1 dependent

Married or 1 dependent

No Medicare Medicare No Medicare 1 w/ Medicare 1 Without Both with Medicare

10-19 years Per Benefit period

$559.00 $2,236.00

$250.00 $1,000.00

$799.00 $3,196.00

$567.00 $2,268.00

$335.00 $1,340.00

20 & Over Per Benefit Period

$481.00 $1,924.00

$220.00 $880.00

$692.00 $2,768.00

$475.00 $1,900.00

$289.00 $1,156.00

Self-Payment Rates for Widows/Disabled Employees under Age 55Effective 4/1/17

Local Union 103 widow or disabled

Local Union 318 widow or disabled

Local Union 649 widow or disabled

Local Union 841 widow or disabled

$3,140.00 $3,140.00 $3,140.00 $3,140.00

Self-Payment Rates for Retirees with Retirement dates AFTER December 1, 2007Effective 4/1/17

Employee Point Total Class 1 Class 2 Class 3

P o i n t Group

If your Employee Point Total (age + Credited Service) at retirement is:

If younger than age 62, the monthly Self-Payment rate is:

If age 62 through 64, the monthly Self-Payment rate is:

If age 65 or older, the monthly Self-Payment rate is:

A 95 or more points $270.00 $270.00 $160.00B 90 up to 94 points $455.00 $455.00 $160.00C 85 up to 89 points $530.00 $530.00 $235.00D 80 up to 84 points $580.00 $580.00 $250.00E* Less than 80 points $630.00 $630.00 $290.00

Rates are based on per person per month

Mid Central Operating Engineers Health and Welfare FundAmendment Number 2

In accordance with the terms of the Mid Central Operating Engineers Health and Welfare Fund, the Board of Trustees hereby amends the Summary Plan Description/Plan Document, 2015 Edition, by adopting the following effective December 1, 2016:

1. Item 7 under “Covered Medical Benefit Expenses” on page 49 of the Summary Plan Description/Plan Document to read as follows:

7. Medically Necessary drugs, prosthetic devices, dressings, and laboratory services, including:

a. Diagnostic X-ray and laboratory service;

b. Oxygen and rental of equipment for its administration;

c. Blood or blood plasma and its administration;

d. Radium, radioactive isotopes, and X-ray therapy;

e. Casts, splints, braces, trusses, and crutches; and f. Artificial limbs and eyes to replace natural limbs and eyes lost, up to the individual

Lifetime maximum, as well as replacement prosthetic limbs and eyes that are Medically Necessary (which includes repairs and maintenance) as listed on the Schedule of Benefits

2. The “Lifetime Maximums” under the Medical Benefits section of the Active Plan – Schedule of Benefits on page 34 is revised to read as follow

Medical Benefits * * * * *Lifetime Maximums

Cochlear Implants Wheelchairs Artificial Limbs or Eyes TMJ

Per Lifetime: No maximum One Wheelchair per person One set of artificial limbs and one set of artificial eyes per person, and Medically Necessary replacements No maximum

* * * * *

3. The “Lifetime Maximums” under the Medical Benefits section of the Retiree Plan for Non-Medicare Eligible Participants – Schedule of Benefits on page 36 is revised to read as follows:

Medical Benefits * * * * *Lifetime Maximums

Cochlear Implants Wheelchairs Artificial Limbs or Eyes TMJ

Per Lifetime: No maximum One Wheelchair per person One set of artificial limbs and one set of artificial eyes per person, and Medically Necessary replacements No maximum

* * * * *

Board of Trustees - Mid CentralOperating Engineers Health and Welfare Fund

1100 Poplar StreetTerre Haute, IN 47807

Summary Annual Report forMID CENTRAL OPERATING ENGINEERS

HEALTH AND WELFARE FUND

This is a summary of the annual report for Mid Central Operating Engineers Health and Welfare Fund, EIN 35-0917610 , Plan Number 501, for the period August 1, 2015 to July 31, 2016. The annual report has been filed with the Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Basic Financial Statement The value of plan assets, after subtracting liabilities of the plan, was $101,260,865 as of July 31, 2016, compared to $96,376,185 as of August 1, 2015. During the plan year the plan experienced a change in its net assets of $4,884,680. This change includes unrealized appreciation or depreciation in the value of plan assets; that is, the difference between the value of the plan’s assets at the end of the year and the value of the assets at the beginning of the year or the cost of assets acquired during the year. The plan had total income of $77,485,274 which included employer contributions of $65,451,622, employee contributions of $8,166,795, other contributions of $0, gain/loss of $-235,985 from the sale of assets, and earnings from investments of $4,138,842.

Total plan expenses were $72,600,594. These expenses included $4,300,949 in administrative expenses and $68,299,645 in benefits paid to participants and beneficiaries, and $0 in other expenses.

Your Rights To Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request.The items listed below are included in that report:

• An accountant’s report• Financial information and information on payments to service providers• Assets held for investment• Fiduciary information, including nonexempt transactions between the plan and parties-in-interest

(that is, persons who have certain relationships with the plan) • Information regarding any common or collective trusts, pooled separate accounts, master trusts, or

103-12 investment entities in which the plan participates

To obtain a copy of the full annual report, or any part thereof, write or call the office of: Board of Trustees - Mid CentralOperating Engineers Health and Welfare Fund1100 Poplar StreetTerre Haute, IN 47807(812)232-4384

The report is furnished without charge.

You also have the right to receive from the plan administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or a statement of income and expenses of the plan and accompanying notes, or both. If you request a copy of the full annual report from the plan administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge.

You also have the legally protected right to examine the annual report at the main office of the plan:

Board of Trustees - Mid CentralOperating Engineers Health and Welfare Fund1100 Poplar Street Terre Haute, IN 47807

and at the U.S. Department of Labor in Washington, DC, or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to:

Public Disclosure RoomRoom N-1513Employee Benefits Security Administration U.S. Department of Labor200 Constitution Avenue, N.W. Washington, DC 20210

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

MINSH1301A Rev. 8/11 F0032529

24/7 NurseLine

Always here for you

Health concerns can happen when you least expect them. You might be on vacation or even on a business trip. Or your child may have a fever in the middle of the night. But there’s somewhere you can turn for help any time of the day or night.

Call the 24/7 NurseLine to talk with a registered nurse about your health concern. Whether it’s a question about allergies, fever, types of preventive care or any other topic, nurses are always there to provide support and peace of mind. And, if you want, a nurse will call you later to see how you’re doing.

Our nurses can help you choose the right place for care if your doctor isn’t available and you aren’t sure what to do. Do you need to head straight to the emergency room? Is urgent care best? Or do you need to see your doctor? Making the right call can save you time and money – and give you access to the best possible care.

Do you speak Spanish or another language other than English? We have Spanish-speaking nurses and translators on call. TTY/TDD services are available, too.

If you’d prefer not to talk about your health concern over the phone, the AudioHealth Library might be for you. These helpful prerecorded messages cover more than 300 health topics in English and Spanish. Just call the 24/7 NurseLine number and choose the AudioHealth Library option.

Health questions?

24/7 NurseLine is always here for you. Call toll free at 888-279-5449.

85% of members like you would recommend 24/7 NurseLine to others.

Mid Central Health & Welfare1100 Poplar StreetTerre Haute, IN 47807

Presorted First Class Mail

U.S. Postage PAIDIndianapolis, IN

Permit 9395

Home About Fund Fund Contact Important Announcements Forms Summary Plan Description Initial Eligibility Benefit Schedules Retiree Rates FAQs Employers Delinquent Contributors Links

Visit our Websit @

www.midcentral.org

Welcome to the Mid Central Operating Engineers Health and Welfare Fund Visit our website, developed to provide our members with access to work history, eligibility, claims history and other valuable information. In order to access your information, you must register under Member Log In. Please have your Identification Number ready, which is located on your Anthem Blue Cross/Blue Shield or Eligibility Card (for retired members).

You also have the ability to view the Summary Plan Description, Benefit Schedules, Retiree Rates and much more. You may also download forms such as claim forms, change of address form, disability statements, and ACH bank forms (for Retirees only).

If you have any questions, please contact us at 1-812-232-4384 or click Fund Contact for toll-free numbers.

We also have included valuable links to other websites for your use.

 

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