The benefits provided for you under the Plan include:

• Death Benefits
• Accidental Death and Dismemberment Benefits
• Survivor Income
• Sickness and Accident Benefits
• Medical Care
• Dental Care
• Vision Care
• Prescription Drug Coverage

Who Qualifies for Health and Welfare Benefits?

Health and welfare benefits are provided by the ITPEU Health and Welfare Fund for active Employees who have eligibility and also for their Covered Family Members. Employees and Covered Family Members who are eligible for benefits from the Fund are known as "Participants". The amount of your benefits is based on the average number of hours you actually work per week and the hourly rate your employer contributes on your behalf.

There are four different benefit levels provided for active Participants as set forth below. The highest level of benefits is available for active Participants who are in Level IV. As you go down each level, the amount of benefits available decreases.

In order to be eligible for benefits under the ITPEU Health and Welfare Fund, you must first fill out an enrollment and beneficiary card and send it to the Fund office directly or through your Shop Steward, Union Representative or Employer. If you are Employed by an Employer on the date the Fund became effective at your place of work, you are immediately eligible for benefits as soon as your card is received and contributions are paid on your behalf. If, for any reason, you are away from work, your eligibility is postponed until you return to active work.

If you are hired after the date the Fund became effective at your place of work, your eligibility date for coverage is the 91st day after your date of hire, provided your enrollment card has been received by the Fund.

To be eligible for benefits for dental prosthetics (bridges, partials or complete dentures, and space maintainers, including adjustment and repair thereto), you must be covered by the Fund for twelve (12) months.

Your eligibility for benefits terminates on the date when you leave the employment of an Employer covered by the Fund or if the Board of Trustees terminates the Fund, whichever happens first. The Board of Trustees may change or eliminate benefits under the Fund and may terminate the entire Fund or any portion of it. The Board of Trustees may terminate the Fund when there is no longer a collective bargaining agreement in force between the Employers and the Union requiring any Employer contributions to the Trust Fund. At any other time, the Fund may be terminated by a unanimous vote of all Trustees, with consent of the Employers and the Union.

Coverage of an eligible child terminates automatically when the child attains 26 years of age. If you request coverage after January 1, 2011 for an eligible child under the age of 26, there will be a 30 day waiting period from the date of your request before such child is enrolled for benefits. If an eligible child becomes totally and permanently disabled prior to attaining the age of 26, the Employee parent of such child must notify the Fund Office of such disability within 60 days of the onset of same. Coverage of a disabled child over 26 ceases if the child is found to be no longer totally or permanently disabled. Coverage of the spouse of an Employee terminates automatically as of the date of divorce or death. Coverage for all family members terminates automatically as of the date of death of the Employee. Any stepchildren who are not enrolled for health coverage from the Fund as of the close of business on December 31, 2010, are not eligible for such coverage.

In the event your Employer is one month delinquent in remitting contributions on your behalf to the Fund, you and your Covered Family Members' eligibility for benefits incurred after a period of 40 days from the commencement of such delinquency shall be suspended until such time as the employer is no longer delinquent for one or more months. During such a period of suspension, the Fund shall hold such claims in abeyance pending payment of the contributions. Once your employer is no longer delinquent for one or more months, such claims will be promptly processed by the Fund.

No later than 10 days after the contributions were due, the Fund shall send written Notice to the Employees of the delinquent Employer, informing them that payment of their benefits, and the benefits of their Covered Family Members, will be suspended in 30 days due to lack of payment by their Employer unless the Employer pays off the delinquency within the 30 day period. Such Notice shall state the actual date of such suspension. Copies of such Notice shall be sent to the Employer, and the applicable Contracting Officer and DOL Wage & Hour Area Director. In addition, a separate letter, with copies to the Employer and affected Employees, will be sent by the Fund to the applicable Contracting Officer and Wage & Hour Area Director, advising of the delinquency and resulting suspensions of benefits.

Death Benefits are payable in the event of your death from any cause at any time or place while you are eligible for benefits. Payment will be made in a lump sum to the beneficiary designated by you.

In the event of the death of a covered family member from any cause while you are eligible for benefits, you will receive the benefit listed in your Schedule of Benefits. Your eligibility for covered family member's death benefits stops when your employment terminates, if your eligibility for benefits ceases, or if you die.

In addition to the death benefits previously described, the Fund will pay a survivor death benefit in monthly installments to your beneficiary in the event of your death from any cause at any time or place while you are eligible for benefits. The amount of each monthly installment and the period of time over which such installments will be paid is based on your classification as set forth in your Schedule of Benefits.

The Fund provides benefits for loss of life, limbs, or the entire and irrecoverable loss of sight, which occurs directly from bodily injuries caused solely through accidental means when the loss occurs within ninety (90) days after the accident.

The Fund pays eligible Employees a weekly benefit while they are disabled and prevented from working provided that they are under the care of a legally qualified physician and their disability results from a non-job related accident, sickness or disease for which benefits are not payable under any workmen's compensation law or any law or policy of insurance providing for the payment of motor vehicle "No-Fault" or First-Party Benefits.

Preferred Provider Organization (PPO) Network

The Trustees of the Fund have engaged Anthem Blue Cross Blue Shield (Anthem) as the Claims Administrator and as the Preferred Provider Organization (PPO) for the Fund.

The Fund provides benefits for certain dental procedures incurred by you or your Covered Family Member.

A vision care benefit is provided for you or your Covered Family Member for an eye examination and toward the purchase of single vision, bifocal or higher vision lenses.

The Fund shall pay prescription drug benefits for a Participant in accordance with the amounts and terms set forth in your Schedule of Benefits, provided that the prescription drugs are obtained pursuant to a prescription issued by a Physician.

All claims for benefits provided by the Plan must be submitted within one (1) year from the date the claim is "incurred".

An application for any benefits described in this Summary Plan Description, other than Medical benefits, must be made in writing on an official Plan claim form. You can obtain the proper form from your Union or Plan representative, or from your Employer. The claim forms can either be sent directly to the Plan Office or can be handed to your Union or Fund representative for transmittal to the Plan Office.

All claims for Death Benefits, Covered Family Member's Death Benefits, Survivor Monthly Death Benefits and Non-Occupational Accidental Death Benefits and Dismemberment Benefits must be submitted to the Plan Office within three (3) years from the date of the death or dismemberment in question. Any claim received by the Plan Office for such benefits more than three (3) years after the date of such death or dismemberment will not be honored and will not be paid.

All other claims for benefits including, but not limited to, medical, dental, vision, prescription drug and sickness and accident benefits, must be submitted to the Plan Office or Claims Administrator within one (1) year from the date the claim is "incurred". A claim shall be considered 'incurred' under the following circumstances:

• A claim for hospital benefits is incurred on the date the Employee or Covered Family Member enters a hospital;
• A claim for weekly accident and sickness benefit is incurred on the first date of disability if it is caused by an accident or on the fourth day of disability if it is brought about by an illness;
• Any other claim for benefits is incurred on the date the service in question is rendered.

Any claim for benefits other than Death Benefits, Covered Family Member's Death Benefits, Survivor Monthly Death Benefits or Accidental Death or Dismemberment Benefits which is received by the Plan Office or Claims Administrator more than one (1) year after such claim is incurred will not be honored and will not be paid.

This depends on the type of benefit involved. For example, a claim for hospital benefits is normally incurred on the date you (or your dependent) enter a hospital; a claim for weekly accident and sickness benefits is incurred on the first day of your disability if it is caused by an accident or on the fourth day of your disability if it is brought about by illness; a claim for death benefits or accidental death and dismemberment benefits is incurred on the date of the death or dismemberment involved. Any other claim for benefits is incurred on the date the service in question is rendered.

The Following Procedures Will be Followed for Claims for Medical Benefits Only:

Effective July 1, 2012, all claims for medical benefits and appeals from denials of such claims shall be handled exclusively by the Claims Administrator (Anthem). It shall be the responsibility of the Participant to give proper notice of any other coverage he or she may have when filing a claim.

General Rule

If an individual is entitled to benefits or services for which benefits are payable under the ITPEU Health and Welfare Plan, and is also covered under any other plan, the benefit provided by the ITPEU Health and Welfare Plan will be coordinated so that the combination of such benefit payments does not exceed the maximum benefit payable by the Plan which has the primary coverage for the claim in question.

It shall be the responsibility of the Participant to give proper notice of any other coverage he or she may have when filing a claim with the ITPEU Health and Welfare Fund for Medical or Dental Benefits.

When you and your spouse are ITPEU Employees eligible for benefits under the Plan, all benefits payable to the couple shall be paid by first exhausting the benefits available to such spouse as an Employee, and then applying the benefits available as a result of such spouse's status as a dependent.

In no event shall the combination of such benefit payments exceed the maximum benefit payable under the Plan for the claim in question or the actual amount of charges for the claim in question.

Benefits for Covered children of such a couple shall be paid by first exhausting the benefits available by virtue of the employment of whichever spouse has been employed longest, or, if employment time is equal, by virtue of the earliest birth date in the calendar year and then applying the benefits available as a result of the employment of the other spouse.

In no event shall the combination of such benefit payments exceed the maximum combined benefit payable under the Plan for the claim in question.

When both a Covered Child and one or more parents are ITPEU Employees eligible for benefits under the Plan, all benefit claims for such Covered Child shall be paid by first exhausting the benefits available to such Covered Child as an Employee and then applying the benefits available as a Covered Child of an Employee.

In no event shall the combination of such benefit payments exceed the maximum combined benefit payable under the Plan for the claim in question.

Some Employees may be employed by two or more ITPEU Employers at the same time, and attain eligibility for benefits from the Plan by virtue of their employment with each such Employer. In such case, benefit claims for such Employee and his/her covered family member shall be paid by first exhausting the benefits available under the job in which the Employee has been employed longest, and then applying the benefits available as a result of his other employment with any other ITPEU Employer.

In no event, shall the combination of such benefit payments exceed the maximum combined benefit payable under the Plan for the claim in question.

All Medical and Dental benefits payable by the Fund shall be deemed assigned by the affected Participant to the Health Care or Dental Provider in question. Medical or Dental benefits shall not be paid directly to a Participant unless the Fund office receives satisfactory evidence that the bill of the Provider in question has been paid in full.

Any time you are hospitalized or receive any form of dental or medical care, it is your responsibility to inform the Hospital or other Health Care or Dental Provider of the full extent of your coverage spelled out in this Booklet.

If you or your Covered Family Member makes claim for benefits from the Fund under circumstances where the injury or illness for which such benefits are claimed gives rise to a claim or lawsuit against a third party, payments of benefits by the Fund shall be made on the condition and with the understanding that the Fund will be reimbursed for payment of such benefits out of any recovery made in your third-party claim. The full details of the Plan's Rules on Subrogation can be found at Section 22 of the Plan.

If you are disabled and no contributions are being made on your behalf, Medical, Vision, Dental and Prescription Drug benefits for you and your Covered Family Members will be continued for a period of six weeks from the date of your last contribution period. To continue Medical, Vision, Dental and Prescription Drug benefits for you or your Covered Family Members following said six-week period, application must be made for Continuation of Coverage ("COBRA") as described in this Booklet, unless you are eligible for leave under the Federal Family and Medical Leave Act. If you do not choose to elect Continuation of Coverage, all benefits for you and your Covered Family Members will cease at the end of six weeks following your last day of work.

Should you and/or your Covered Family Members lose eligibility for the medical care, vision care, dental care or prescription drug benefits provided by the Plan, you may be entitled to elect continuation coverage in accordance with federal law. If your employer normally employs twenty or more people, and your employment is terminated for any reason other than gross misconduct you have certain rights under certain conditions to continue your coverage under a federal law known as the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).

The Federal Family and Medical Leave Act ("FMLA") provides that eligible employees are entitled up to twelve (12) weeks of unpaid leave for the following circumstances:

Birth Control benefits shall be payable only to female employees or female spouses of employees.

For the purpose of computing medical benefits, maternity is treated as any other illness for female employees or covered family member wives. Covered children are not covered for maternity benefits.

The Plan provides benefits for maternity care at a freestanding facility that meets certain requirements.

Under this law, group health plans may not restrict benefits for any hospital length of stay in connection with child birth for the mother or newborn child to less than forty-eight (48) hours following a normal vaginal delivery, or less than ninety-six (96) hours following a Caesarian Section. However, this law does not generally prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or newborn earlier than forty-eight (48) hours or ninety-six (96) hours as applicable. In any case group health plans may not, under federal law, require that a health care provider obtain authorization from the Plan for prescribing a length of stay not in excess than forty-eight (48) hours (or ninety-six (96) hours if applicable). This Plan is in compliance with this federal law.

On October 21, 1998, Congress enacted the Women's Health and Cancer Rights Act of 1998. Under this law, group health plans that provide coverage for mastectomies must also cover reconstructive surgery and prostheses for mastectomy patients. This law requires that a member receiving benefits for a medically necessary mastectomy must also be eligible to receive benefits for:

• Surgical reconstruction of the breast on which the mastectomy has been performed;
• Surgical reconstruction of the other breast to produce a symmetrical appearance;
• Prostheses and treatment of physical complications, including lymphedemas, associated with all stages of the mastectomy procedure.

Your benefit will be determined by your Class of Coverage and the type of benefits which are provided by your Schedule of Benefits.

The Plan does not provide coverage for certain items. Please refer to your complete Plan documentation for a full list of exclusions and limitations.

To name a beneficiary, simply complete the enrollment and beneficiary card furnished to you by your union representative, Fund representative or employer. The card must then be sent to the Fund office.

The Fund collects information about you to help us provide Plan benefits to you and your Covered Family Members, and to fulfill legal and regulatory requirements. The Board of Trustees considers all information about you in possession of the Plan to be personal information, even if you cease to be a Plan participant. The personal information we collect may include, among other things, health information necessary to administer your benefits.

The Plan has adopted policies and procedures designed to protect your personal information from unauthorized use or disclosure. Thus, the Board of Trustees has implemented physical, electronic and procedural safeguards to maintain the confidentiality and integrity of the personal information in our possession and to guard against unauthorized access. These measures include, among other things, procedures for controlling access to participants' files, building security programs and information technology security measures such as the use of passwords, encryption and firewalls, plus virus and use detection software.

The Board of Trustees continues to access new technology as it becomes available and to upgrade our physical and electronic security systems as appropriate.

The Fund's policy is to permit Fund employees and professionals employed by the Fund to access your personal information only if they have a legitimate purpose for using such information, such as administering the Plan, reviewing and analyzing claims and requests for review of claim denials, and/or providing Plan benefits to participants. Any other use or disclosure of your personal information shall be made only with your written authorization, which such authorization may be revoked by you at any time in writing.

You have certain rights regarding your health information that is maintained by the Fund. Those rights include the ability to access your health information, request corrections, and receive an accounting of disclosures, among other protections under HIPAA regulations.

As a participant in the ITPEU Health & Welfare Fund you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA).

ERISA provides that all plan participants shall be entitled to:

• Examine, without charge, at the plan administrator's office and at other specified locations, such as union offices, all plan documents, including insurance contracts, collective bargaining agreements and copies of all documents filed by the plan with the U.S. Department of Labor, such as detailed annual reports and plan descriptions.
• Obtain copies of all plan documents and other plan information upon written request to the plan administrator. The administrator may make a reasonable charge for the copies.
• Receive a summary of the plan's annual financial report. The plan administrator is required by law to furnish each participant with a copy of this summary annual report.

In addition to creating rights for the plan participants, ERISA imposes duties upon the people who are responsible for the operation of the plan. The people who operate your plan, called "fiduciaries" of the plan, have a duty to do so prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the plan or exercising your right under ERISA.

If your claim for a benefit is denied in whole or in part, you must receive a written explanation of the reason(s) for the denial. You have the right to have the plan review and reconsider your claim. Under ERISA there are steps you can take to enforce the above rights. For instance, if you request materials from the Plan and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the plan administrator to provide the materials and pay you up to $100 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the plan administrator.

If you have a claim for benefit which is denied in whole or in part, you may file suit in a state or federal court. If it should happen that plan fiduciaries misuse the plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the persons you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

If you have any question about your plan, you should contact the plan administrator. If you have any questions about this statement, or about your rights under ERISA, you should contact the nearest Area Office of the Employee Benefits Security Administration, U.S. Department of Labor.