To all participants

BENEFIT MODIFICATIONs effective May 1, 2009

This is an announcement of a material modification to the United Teamster Fund.

The primary problem in health care is one of cost.  As we all know, huge increases to health care costs every year have been a nationwide problem.  This Fund has provided millions of dollars in benefits to its participants over the years.

As a result of spiraling costs, in order to continue to provide health and welfare benefits that will protect our participants and their families, the Trustees made adjustments to the benefits.  We believe these changes will provide the coverage that addresses our participants’ concerns.

Attached is a summary of the changes.

Please read them carefully and call the Fund Office if you have any questions.

Thank you for your attention.

Sincerely,

Board of Trustees

UNITED TEAMSTER FUND
MAY 1, 2009 BENEFITS


ELIGIBLE SERVICES AND SUPPLIES

IN-NETWORK
Prior to May 1, 2009

IN-NETWORK
After May 1, 2009

Adult Preventative

$20 copay; then 20% coinsurance

$25 copay

Infant and Pediatric Preventative Care

$20 copay; then 20% coinsurance

$25 copay

Primary Care Office Visits

$20 copay; then 20% coinsurance

$25 copay

Specialist Office Visits

$30 copay for initial visit; then 20% coinsurance; $20 copay for follow up visit

$40 copay

PreNatal-Post Natal Maternity Care (Physician’s Charges)

20% coinsurance

$25 copay for initial visit

Allergy Care

$20 copay; then 20% coinsurance

$40 copay

Chiropractic Care

$20 copay; then 20% coinsurance; up to $1,000 per year*

$40 copay; up to $1,000 per year*

Outpatient Facility Surgery

20% coinsurance; up to $3000

$100 copay; 20% coinsurance; up to $3,000

Laboratory Services

$20 copay; then 20% coinsurance

$25 copay

MRIs, MRAs, PET ScanCAT Scan, Ultrasound, and Radiology

$10 copay; then 20% coinsurance

20% coinsurance

Physician’s and Surgeon’s
Services (in-hospital)

20% coinsurance

Deductible and 20% coinsurance

InPatient Hospital

100%; after $500 copay per admission

Deductible and 20% coinsurance

Ambulance Service

Covered up to $500

Deductible and 20% coinsurance

Hospital Emergency Room

$100 copay, waived if admitted

$100 copay, waived if admitted

Emergency Room Physician

20% coinsurance

20% coinsurance

Emergency Care in Urgi-Care

 

$40 copay

Skilled Nursing Care

100%; up to 30 days per year*

Deductible and 20% coinsurance; up to 30 days per year*

Hospice Care – Inpatient or Outpatient

20% coinsurance; up to 210 days per lifetime

Deductible and 20% coinsurance

Hospice Care – Home

20% coinsurance; up to 210 days per lifetime

20% coinsurance

Home Health Care (with discharge)

20% coinsurance; up to 60 visits per year*

20% coinsurance; up to 40 visits per year*

Home Health Care (without discharge)

$50 copay; then 20% coinsurance; up to 60 visits per year*

$50 copay; then 20% coinsurance; up to 40 visits per year*

Short-Term Rehab-Inpatient

20% coinsurance

Deductible and 20% coinsurance; up to 30 days per year*

Short-Term Rehab-Outpatient

20% coinsurance

$40 copay; limited to 60 visits per year*

Durable Medical Equipment

$20 copay; then 20% coinsurance

Deductible and 20% coinsurance

Elective Termination of Pregnancy

$20 copay; then 20% coinsurance

$40 copay

DEDUCTIBLES AND COINSURANCE


Annual Deductibles

None

$1,000/Single;
$2,000/Family

Coinsurance
(Amount Member Pays)

20%

20%

Annual Maximum Out of Pocket  For any plan year you will not pay more than:

N/A

$3,000/Single;
$6,000/Family; including deductible

Annual Benefit Period Maximums

N/A

$500,000

Lifetime Maximums

$250,000 per lifetime

N/A- Eliminated

* The year is May 1st to April 30th

UNITED TEAMSTER FUND
MAY 1, 2009 BENEFITS


ELIGIBLE SERVICES AND SUPPLIES

OUT OF NETWORK
Prior to May 1, 2009

OUT OF NETWORK
After May 1, 2009

Adult Preventative

$500 Deductible and 20% of Magnacare Allowance

Not Covered

Infant and Pediatric Preventative Care

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Primary Care Office Visits

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Specialist Office Visits

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

PreNatal-Post Natal Maternity Care (Physician’s Charges)

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Allergy Care

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Chiropractic Care

$500 Deductible and 20% of Magnacare Allowance; $1,000 per year*

Deductable and 40% of Magnacare Allowance; $1,000 per year*

Outpatient Facility Surgery

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Laboratory Services

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

MRIs, MRAs, PET ScanCAT Scan, Ultrasound, and Radiology

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Physician’s and Surgeon’s
Services (in-hospital)

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

InPatient Hospital

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Ambulance Service

Covered up to $500

Deductible and 40% of Magnacare Allowance

Hospital Emergency Room

$100 copay, waived if admitted

$100 copay, waived if admitted

Emergency Room Physician

20% of Magnacare Allowance

20% of Magnacare Allowance

Emergency Care in Urgi-Car*

 

Deductible and 40% of Magnacare Allowance

Skilled Nursing Care

20% of Magnacare Allowance; up to 30 days per year*

Deductible and 40% of Magnacare Allowance; up to 30 days per year*

Hospice Care – Inpatient or Outpatient

$500 Deductible and 20% of Magnacare Allowance; up to 210 days per lifetime

Deductible and 40% of Magnacare Allowance; up to 210 days per lifetime

Hospice Care – Home

$500 Deductible and 20% of Magnacare Allowance; up to 210 days per lifetime

Deductible and 40% of Magnacare Allowance; up to 210 days per lifetime

Home Health Care (with discharge)

$500 Deductible and 20% of Magnacare Allowance; up to 60 visits per year*

Deductible and 40% of Magnacare Allowance; up to 60 visits per year*

Home Health Care (without discharge)

$500 Deductible; then 20% of Magnacare Allowance; up to 60 visits per year*

$50 copay; then 40% of Magnacare Allowance; up to 60 visits per year*

Short-Term Rehab-Inpatient

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Short-Term Rehab-Outpatient

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Durable Medical Equipment

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

Elective Termination of Pregnancy

$500 Deductible and 20% of Magnacare Allowance

Deductible and 40% of Magnacare Allowance

DEDUCTIBLES AND COINSURANCE


Annual Deductibles

$500 per person

$3,000/Single;
$6,000/Family

Coinsurance
(Amount Member Pays)

20% of Magnacare Allowance

40% of Magnacare Allowance

Annual Maximum Out of Pocket  For any plan year you will not pay more than:

N/A

$13,000/Single;
$26,000/Family;
 including deductible

Annual Benefit Period Maximums

N/A

$500,000

Lifetime Maximums

$250,000 per lifetime

N/A Eliminated

* The year is May 1st to April 30th