SUP Welfare Plan

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.

January, 2019

Kaiser Prescription Drug Copayment
Reimbursement Procedures

All prescription copayment receipts submitted to the Welfare Plan for reimbursement must indicate the name of the patient. Due to patient privacy considerations, Kaiser of Northern and Southern California has discontinued providing this information on prescription receipts without authorization from the Plan participant. Therefore, when SUP Members pickup prescriptions from Kaiser they should request and complete a form entitled “Authorization for Use and Disclosure of Pharmacy Information.”  With this information on file, Kaiser will provide the Plan participant with a detailed print-out of prescriptions purchased which includes all the information necessary for the Plan Office to process the participant’s claim for copay reimbursements.
If the participant forgets to request and complete the “Authorization for Use and Disclosure of Pharmacy Information” form, a photo of the prescription bottle label showing the participant name, drug name and prescription number may be submitted with the prescription receipt for reimbursement.
Reimbursement for Vision Care
The vision care benefit for active participants is allowed once in a 24-month 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 name and address of the provider of services, the patient’s name, date of service, and an itemization of the charges. 
The vision care allowance for pensioners is included in the $1,500.00 maximum of the Pensioners Annual Allowance for medical, dental, and vision co-payments. Glasses are an allowable expense once in a fiscal year. The fiscal year runs from August 01 to July 31 of the following calendar year. The Member and the covered spouse are both eligible for the vision care benefit under the Pensioners Annual Allowance. 
Unfit for Duty
It is important to inform the SUP Welfare Plan office when you become Unfit For Duty and have doctor’s documentation of your Unfit For Duty sent to the Plan office. The Plan office should be notified and documentation sent when the Unfit For Duty occurs. Contractual obligations require the Plan to act in a timely manner. Any delay may limit our ability to make corrective actions to help you. Updated information should be sent as your situation progresses.
Termination of Coverage and Reestablishing Coverage
If coverage is terminated, you must enroll in a Plan again after you have worked the required time for new eligibility. Re-enrollment in a Plan is not automatic when you begin working again.