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Retiree Health Plan

Welcome to the Sheet Metal Workers’ Retiree Health Plan of Southern California, Arizona & Nevada.

Welcome to the Sheet Metal Workers’ Retiree Health Plan of Southern California, Arizona & Nevada.

Beginning with pension benefits effective July 1, 2016 and after, eligibility for Retiree Health Plan coverage is limited to participants with at least 15 years of Pension Credit earned in this Plan, (Reciprocal Credits will not : In addition, a total of two of the pension credits must be earned in the 60 months (5 years) prior to the effective date of pension benefits during which time contributions must have been made to the Health Plan. Retiree Health coverage is limited to HMO/ EPO coverage available in contracted service areas.)

Please note that not all Plans are available in all areas. To enroll you must reside in your selected Plan’s covered service area, as defined by your zip code. If you do not reside in a contracted service area, you are not eligible for Retiree Health coverage. If you should move outside the contracted plan’s service areas, or if the contracted plans no longer provide service in your area, Retiree Health coverage will terminate.

Eligible for Medicare?

If you (or an eligible dependent) are eligible for Medicare, you (or the dependent) must enroll in Medicare Parts A and B. Do NOT enroll in any Medicare Part D prescription drug coverage. In addition, you (or the dependent) must enroll in your HMO’s Medicare and assign your (or the dependent’s) Medicare benefits to your HMO. Failure to comply may result in termination of your (or your eligible dependent’s) coverage under the Retiree Health Plan! If your HMO Plan does not contract with Medicare in your area, it may be necessary for you to change plans upon your (or your eligible dependent’s) Medicare eligibility date. If there is no HMO contracted with Medicare in your area, there may be no coverage available to you. If you (or an eligible dependent) become eligible for Medicare before reaching age 65, you must notify the Administrative Office immediately.

Your Monthly Self-pay Contribution is based on the retiree’s age, Years of Pension Credit, number of years retired, and whether dependants are covered. Self-Pay contributions will be deducted from your monthly pension benefit check. Please be advised, however, if your pension benefit is not large enough for the self-pay deduction, you will be required to remit monthly payments to the Administrative Office, in order to continue health coverage under the Retiree Health Plan. All payments for coverage are due in the Administrative Office no later than the 20th of the month prior to the month of coverage. For example, your mayment for January 2018 coverage, made payable to Sheet Metal Workers’ Retiree Health Plan, is due in the Administrative office no later than December 20, 2017. Failure to remit a timely payment will result in a termination of coverage. The Administrative Office does not send bills or reminder notices.

  • Moving? Please be sure to notify the Administrative Office, in writing, immediately. This will ensure that you do not experience a lapse in coverage, and continue to receive all necessary and important information regarding your health coverage.

If you have any questions, please do not hesitate to contact the Eligibility Department. We are here to assist you!

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