Section 15.01 Retiree Health Benefits

  The Plan offers certain limited retiree health benefits.  These retiree health benefits are ancillary benefits and do not in any way constitute a part of a Pensioner’s or Beneficiary’s Accrued Benefit.  Retiree health benefits are subordinate to the Plan’s retirement benefits, and at no time after the date on which the Plan first provides retiree health benefits shall the amount of contributions by Contributing Employers for health benefits plus any death benefit protection exceed 25% of the aggregate contributions made after such date other than contributions to fund past service credits.

The retiree health benefits payable before January 1, 1999, and eligibility for such benefits, are described in a separate document available from the Fund Office.  The eligibility rules in effect on or after January 1, 1999, and before January 1, 2002, for retiree health benefits are described in Appendix A.  The eligibility rules in effect on or after January 1, 2002, and the rules for retiree health benefits in effect on or after January 1, 1999, are as follows:

(a)                Eligibility –

(1)        With respect to a Payee or Eligible Dependent who becomes eligible to receive benefits under this Section on or after January 1, 2002, the Payee’s or Eligible Dependent’s eligibility for a retiree medical benefit shall commence on the first day of the first month on which all of the following conditions have been satisfied:

(A)              (i) with respect to benefits payable to a Payee, the Payee is enrolled in Medicare Parts A and B, or (ii) with respect to benefits payable to an Eligible Dependent, the Eligible Dependent is enrolled in Medicare Parts A and B;

(B)              (i)  with respect to benefits payable to a Payee or an Eligible Dependent for any reason other than the Payee’s death, the Payee has, from the Effective Date of Pension, been a member in good standing of the Union, or (ii) with respect to benefits payable to an Eligible Dependent, the Payee is (or, if the Payee is deceased, was upon his or her death) a member in good standing of the Union;

(C)    on or after the following effective dates, Payee worked 3500 Hours of Work in Covered Employment during the five consecutive Calendar Years immediately preceding the Calendar Year of his Effective Date of Pension in a job classification under a Collective Bargaining Agreement or other agreement that provides that the Contribution Rate on behalf of his or her job classification is at least:

(D)              the Effective Date of Pension in subsection (C) above shall mean the Effective Date of  Pension under the Plan, or, if earlier, the date on which the Participant began to receive pension benefits under another multiemployer defined benefit pension plan that is, on the date the Participant retires under the Plan, a party to the International Reciprocal Agreement for Sheet Metal Workers' Pension Funds; and

(E)               the Payee has made application for his or her retiree medical benefit on a form provided by the Fund and has presented satisfactory evidence that the foregoing conditions are satisfied.

(2)        Such a Payee’s or Eligible Dependent’s eligibility for retiree medical benefits shall cease on the day on which one or more of the preceding conditions are no longer met.

(b)        Additional Provisions Regarding Cessation of Eligibility -  Any Payee’s or Eligible Dependent’s eligibility for retiree medical benefits shall cease:

(1)        in the event of the Payee’s failure to remain a Union member in good standing from the later of the Effective Date of Pension or January 1, 2002 until his date of death; or 

(2)   (i)  on or after the following effective dates and except as provided below, in the event the Local in which the Payee was most recently employed before retirement ceases to have a negotiated Contribution Rate of at least the amount listed below for the Payee's last Contributing Employer or for the Payee's former bargaining unit, the Payee and Eligible Dependent's retiree medical benefits will permanently terminate effective January 1 of the subsequent Calendar Year.

     (ii)   This subsection (b)(2) will not apply if the failure to pay the required Contribution Rate is the result of the last Contributing Employer ceasing affiliation with the Union, or in the case of Non-Construction work, the last employer has gone out of business.

(3)        in the event that the Payee and the Eligible Dependent cease to receive monthly pension benefits from the Plan; or

(4)        in the event the Payee, and Eligible Dependent associated with the Payee, would not have been entitled to a full death benefit under section 7.01 by virtue of employment in the Sheet Metal Industry that is not covered by a collective bargaining agreement between the Union and the Employer.

(c)        Benefits – The Plan shall pay a monthly benefit on behalf of each eligible Payee or Eligible Dependent toward the cost of Medicare supplemental coverage actually obtained by the Payee or Eligible Dependent from any Eligible Provider of such coverage as may be selected by the Payee or Eligible Dependent.  Effective for existing Eligible Providers as of September 1, 2001, and for new Eligible Providers as of January 1, 2002, the monthly benefit may be applied toward the cost of Medicare supplemental coverage provided that the Payee or Eligible Dependent is subject to a charge for such coverage.  The amount of the monthly benefit shall be the lesser of $31 or the total monthly premium charged the Payee or Eligible Dependent by the Eligible Provider for Medicare supplemental coverage.  For purposes of this Article:

(1)               “Medicare supplemental coverage” shall mean (A) coverage under a Medicare supplemental policy, as that term is defined in 42 USC § 1394ss(g), plus (B) coverage under a welfare benefit plan subject to the provisions of Title I of ERISA which the Trustees, in their sole discretion, have determined is sufficiently similar in nature to coverage under a Medicare supplemental policy, as so defined, and not otherwise foreclosed under the provisions of this subsection (c).

(2)               Effective August 1, 2002, an "Eligible Provider" shall be any multiemployer health plan that is maintained under a Collective Bargaining Agreement between the Union and the Employer and the Sheet Metal Workers' Health Plan, that offer Medicare supplemental coverage to the Payee or an Eligible Dependent and shall have provided to the Plan such certification and acknowledgement as the Plan may require.  Any person with coverage from an entity other than an Eligible Provider as now defined herein, prior to August 1, 2002, may continue to receive the Retiree Health Benefit through December 31, 2002 but thereafter may only receive the benefit if enrolled with an Eligible Provider as now defined.

(3)               Effective August 1, 2002, a “Payee” shall mean a Pensioner whose last employment in the Sheet Metal Industry was under a collective bargaining agreement or other agreement between an employer and the Fund.  

(4)               An “Eligible Dependent” shall mean the Payee’s spouse, or a child of the Payee who has been determined to be disabled for purposes of Medicare except that a spouse of a deceased Payee shall cease to be an Eligible Dependent upon remarriage.

The Plan’s liability is hereby expressly limited to providing the foregoing retiree medical benefit to eligible Payees and Eligible Dependents.  The Plan specifically does not offer or provide Medicare supplemental insurance or any other type of medical insurance.

(d)        Special Transition Rule for Spousal Eligibility – Effective January 1, 2002, notwithstanding any provision of this Article 15 to the contrary, in the event that one spouse is eligible for, and receiving (except for death), retiree health coverage under Article 15 before his or her spouse, the eligibility rules in effect at the time of the earlier application will be applied.

Section 15.02 Contribution Rate

The contributions required to support the retiree health benefits provided to Payees and Eligible Dependents shall be determined by multiplying the number of individuals who are entitled to the retiree health subsidy by the amount of the subsidy, dividing that number by the average monthly income received by the Fund as determined bi-annually, and rounding up to the next highest whole percentage number.  Upon receipt of the contributions by the Fund, such contributions shall be allocated to a separate account. 

Section 15.03 Separate Account

All amounts determined under Section 15.02 and the earnings thereon shall be maintained in a separate account, and such assets may not be used for or diverted to any purpose other than to provide such retiree health benefits.  Similarly, none of the assets accumulated to provide retirement benefits may be used for or diverted to provide the retiree health benefits.  Any reserves accumulated in the separate account may be invested to the extent permitted by the Agreement and Declaration of Trust.  The separate account shall be maintained in accordance with Section 401(h) of the Code. 

Section 15.04 Termination

In the event of termination of the retiree health benefits provided under this Article, the following rules will apply:

(a)        No Payee (including any Eligible Dependent claiming through the Payee) whose retirement date is subsequent to the termination date will receive or be entitled to any retiree health benefits.

(b)        The assets accumulated in the separate account established to maintain the retiree health benefits, if any, shall be used to continue benefits to Payees and Eligible Dependents who were eligible for them prior to the termination date so long as any assets remain.  However, if after the satisfaction of all benefits provided herein there remain any assets, such remainder shall be distributed in accordance with the requirements of Section 401(h) of the Code. 

Section 15.05 Forfeitures

In the event any individual’s interest in the retiree health benefits is forfeited prior to the termination of the Plan an amount equal to the amount of the forfeiture will be applied as soon as possible to reduce Employer contributions to fund the retiree health benefits.