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Pile Drivers_ Divers_ Bridge_ Dock _ Wharf Builders Health

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					      Pile Drivers, Divers,
     Bridge, Dock & Wharf
            Builders
     Health & Welfare Plan




        Hour Bank Eligibility
               And
         Benefit Summary
                          Revised January 1, 2009




Revised: March 10, 2009          Pile Drivers –PIWDbook Elig p   Page 1 of 19
                                TABLE OF CONTENTS


LIST OF BENEFITS ......................................................................................... 5

GENERAL INFORMATION ........................................................................... 5
 HOW DO YOU ESTABLISH COVERAGE IN THE PLAN? ....................... 5
 HOW ARE HOURS REPORTED?................................................................. 6
 WHEN DOES COVERAGE START?............................................................ 6
    Hour Bank System ...................................................................................... 6
 HOW DO YOU MAINTAIN COVERAGE IF UNEMPLOYED?................. 7
 WHEN DOES COVERAGE END? ................................................................ 8
 IF COVERAGE ENDS, WHEN WILL COVERAGE START
 AGAIN? .......................................................................................................... 8
 IN CASE OF INJURY OR ILLNESS ............................................................. 8
 DEPENDENT COVERAGE ........................................................................... 9
SUMMARY OF BENEFITS........................................................................... 11

BENEFIT DESCRIPTIONS ........................................................................... 15
    … for benefits not described in the Benefits Booklets.............................. 15
  EMPLOYEE AND FAMILY ASSISTANCE PROGRAM .......................... 15
  BASIC MEDICAL ........................................................................................ 16
  DIVERS’ MEDICAL EXAMINATIONS..................................................... 16
OTHER BENEFITS NOTES.......................................................................... 16
 “REASONABLE AND CUSTOMARY”...................................................... 16
   What can I do? .......................................................................................... 17
FURTHER INFORMATION ......................................................................... 18
NOTICE

This booklet is intended to summarize the principal features of your
plan. This booklet, together with the Summary of Benefits and the
detailed benefit booklets issued by Pacific Blue Cross, Manulife and
Great West Life (“the Benefits Booklets”), contain a summary of your
Plan as of November 1, 2008. The Plan is subject to change at any time.
If the Plan changes, the Trustees will send covered members
information about the change, including an updated Summary of
Benefits.
This booklet does not give the details of your coverage. All rights to
benefits are governed by the group insurance contracts and the terms of
the Plan. For detailed information about your benefits, please see the
Benefits Booklets provided by the insurance carriers.

             GROUP NO. 903404 (Active) and 003604(Retired)
              - Pacific Blue Cross and BC Life and Casualty
             (Extended Health, Dental, Short Term Disability)

GROUP NO. 29005 – The Manufacturers Life Insurance Company
   (Class A – Active Members; Class B – Retired Members)
              (Group Life and AD&D Insurance)

  GROUP NO. xxxxx – The Great-West Life Assurance Company
             (Long Term Disability Insurance)

            GROUP NO. 3134046 - Medical Services Plan of BC
                     (Basic Medical Coverage)




Revised: March 10, 2009         Pile Drivers –PIWDbook Elig p             Page 3 of 19
The Pile Drivers’, Divers’, Bridge Dock and Wharf Builders’ Health &
Benefit Plan covers:
1.           Member Assistance Plan (MAP) *
2.           Basic Medical Coverage
3.           Dental Plan
4.           Extended Health Care (EHC)
5.           Short Term Disability (STD), integrated with EI sick benefits
6.           Long Term Disability (LTD)
7.           Group Life Insurance
8.           Accidental Death and Dismemberment Insurance (AD&D)
9.           Spousal Life Insurance
10.          Divers Medical Examinations (Divers only)
11.          Retired Members Life Insurance**
12.          Retired Members AD&D Insurance**
13.          Retired Members Spousal Life Insurance**
14.          Retired Members Mini-Health Plan**
* available to ALL members in good standing of Local 2404, even if
not covered on the hour bank.
** not eligible unless pension payments started on or before December
1, 2002.
See the Summary of Benefits tables and the individual benefit
descriptions for details of coverage.




HOW DO YOU ESTABLISH COVERAGE IN
THE PLAN?
1.           You must be a member in good standing of the Pile Drivers,
             Bridge, Dock and Wharf Builders Union Local 2404.
2.           You must be enrolled in the Plan by completing an application
             card listing yourself and dependents. You may not claim
             coverage even if you have sufficient hours to qualify, until the

Revised: March 10, 2009            Pile Drivers –PIWDbook Elig p                Page 5 of 19
           Application Card has been completed and forwarded to the
           Plan Office.
  3.       You must have a minimum of 200 hours, within a period of
           six consecutive months, reported and paid into the Plan by
           your employer(s).

  HOW ARE HOURS REPORTED?
  Your Collective Agreement requires that employers report by the 15th
  day of each month, all hours worked by you in the preceding calendar
  month.

  WHEN DOES COVERAGE START?
  Union members who have filled out an application card will have
  coverage commencing on the first day of the month following the
  month in which sufficient hours are reported to the Plan by your
  employer(s).
  EXAMPLE:
 Month Worked                 Member A                      Member B
                            Hours Reported                Hours Reported
January                          140
February                           -                             140
March                              -                             140
April                             50                          reporting
May                              140                           covered
June                          reporting                           -
July                           covered                            -
  Any hours that are not used within 6 consecutive months to establish
  eligibility for coverage (that is, hours that are 7 or more months old) go
  into the General Fund of the Plan.
  The Plan Office will notify you when you are eligible for coverage.
  Hour Bank System
  Once you are covered, all the hours your employer reports for you
  accumulate in your hour bank. Each month, 100 hours are deducted for
  your coverage.
You may accumulate up to 1000 hours (10 months of future coverage)
in your hour bank to carry you through periods of poor employment or
vacation, providing you remain a member of the Union. Any hours in
excess of 1000 go into the General Fund of the Plan.
If your hour bank falls below 100 hours, you may use the self-payment
option to remain covered, as explained below.

HOW DO YOU MAINTAIN COVERAGE IF
UNEMPLOYED?
When your hour bank has less than 100 hours, you are no longer
covered by the Plan. However, you have the option of paying for the
coverage yourself, at the current shortage rate, for up to 12 months.
NOTE: You do not have STD or LTD coverage while self-paying.
You will be notified by mail when your hour bank falls below the 100-
hour minimum and told the amount of self-payment required and the
date by which it must be paid. You may also check your records at any
time with the Plan Office.
Example:
      Monthly coverage required                                100 hours
      Your hour bank balance is                                 45 hours
      Therefore, you are short                                  55 hours
To retain coverage for that month, you must pay $80.85 (55 hours @
$1.47 per hour). The maximum shortage payment is $147.00 a month,
based on 100 hours @ $1.47 per hour. (Rate as of September 1, 2007.
The rate is adjusted each September to 50% of the cost of benefits,
excluding disability).
Do not ignore the shortage notice!
You could lose your coverage if you fail to respond. If you make a self-
payment and late hours are reported or other adjustments are found
later, all hours will be credited to your hour bank for future coverage.




Revised: March 10, 2009        Pile Drivers –PIWDbook Elig p               Page 7 of 19
The only sure way to continue your coverage is to pay the Shortage
by the date specified on the Notice.

WHEN DOES COVERAGE END?
Coverage is always provided on a whole month basis only, and will be
terminated for you and your dependents, when:
1.       Your Hour Bank falls below 100 hours and you fail to make a
         cash payment by the specified date to bring your Hour Bank
         up to the required 100 hours, or
2.       You cease to be a member of the Union.
If you die while a covered member, your hour bank will be run-out to
provide transitional coverage for your dependents. Dependents of
deceased members are not allowed to self-pay to continue coverage
beyond that.

IF COVERAGE ENDS, WHEN WILL
COVERAGE START AGAIN?
When 200 hours have been worked and reported to the Plan. This is the
same as new member commencement outlined at the beginning of this
section.
You may not re-qualify by self-payment.

IN CASE OF INJURY OR ILLNESS
If you are injured or become ill, contact your Union office, the Plan
office or BC Life immediately to find out whether you are entitled to
Short term Disability (STD) and Long Term Disability (LTD) benefits.
If you are, the claim form will be sent to you.
The STD and LTD benefits are described in the Benefits Booklets.
Other disability benefits are available from this Plan and other sources.
They include:
A. Continuation of Full Coverage (Short Term)
     You will receive full credit of 100 hours a month to maintain your
     hour bank and coverage in the Plan as long as you are disabled and
     receiving one of the following benefits:
      •      Short term Disability (STD),
      •      Workers Compensation (WCB) Wage Loss (including income
             continuity and rehabilitation allowance), or
      •      Employment Insurance (EI) Sickness.
      BC Life will automatically advise the Plan Office when you are
      receiving STD. You must provide cheque stubs or other
      documentation as proof of WCB, or EI benefits.
B. Other Disability Benefits
      1.     Canada Pension Plan
             Pensions may be available from the Canada Pension Plan
             (CPP) for severe and prolonged disabilities, both occupational
             and non-occupational, provided you meet the qualifications.
             There is a three-month waiting period before benefits begin,
             but you should apply as soon as possible if your disability is
             severe and likely to be prolonged. Apply for these benefits at
             your local CPP office, listed in the blue pages of your
             telephone directory.
      2.     Group Life and AD&D Insurance
             Both your Life and AD&D insurance may be continued to age
             65 if you become “totally disabled” while covered. See the
             Total Disability provisions in those sections of the Benefits
             Booklets. Because this is continued at no cost to you , it is
             called “Waiver of Premium”. If you apply for LTD, you
             should apply for Waiver of Premium at the same time. The
             Plan office can supply and explain the application forms.
C. Continuation of Coverage (Long Term)
      If you remain disabled at the end of your WCB wage loss period,
      and receive a permanent partial or total disability pension from the
      WCB, you may apply to the Trustees to continue coverage on the
      Plan by paying the full cost of benefits.
             Note: This coverage does not include STD or LTD.

DEPENDENT COVERAGE
Your eligible dependents will be covered for Extended Health Care and
Dental Benefits and for Basic Medical (MSP-BC), but you must


Revised: March 10, 2009            Pile Drivers –PIWDbook Elig p              Page 9 of 19
register them in the Plan for this coverage to take effect. Your eligible
dependents are:
• your spouse; and
• your dependent children to age 21 (age 19 for MSP-BC); and
• your dependent children to any age (age 25 for MSP-BC) who are
     attending a recognized school or college full time (you must be
     prepared to prove dependency); and
• your dependent children to any age who are physically or mentally
     disabled who dependent on you for support and for whom you are
     entitled to an income tax exemption, provided each child was
     covered by the Plan immediately prior to his or her 21st birthday.
"Spouse" means your legal spouse or a person who has been living with
you in a common-law relationship for at least one full year and who is
publicly represented as your spouse.
Dependents are not included in your Weekly Indemnity, Life Insurance,
and Accidental Death & Dismemberment coverage.
New dependents are not covered until you register them.
Dependent children must be added within sixty days from the date of
birth or from the date the child became a dependent, and spouses within
sixty days of the date of marriage.
To have new dependents included in your coverage, you must provide
Pacific Blue Cross with their names and birthdates. Ask the Plan Office
or the Union for the registration form.
The following tables summarize your plan:
               GROUP LIFE INSURANCE and
     ACCIDENTAL DEATH AND DISMEMBERMENT
                         (AD&D)
   Insured by: The Manufacturers Life Insurance Company
                       (“Manulife”)
                      (GROUP 29005)
                   TYPE                             GROUP LIFE
               Active Member                      $75,000 (Member)
                                                   $30,000 (Spouse)
             Retired Member*                      $3,000 (Member)
                                                   $3,000 (Spouse)

                  TYPE                         AD&D Principal Sum
              Active Member                    $75,000 (Member only)
             Retired Member*                    $3,000 (Member only)
        Life insurance premiums paid by the Plan are a taxable benefit.
           *If covered at retirement on or before December 1, 2002.

             SHORT TERM DISABILITY (STD)
                         Insured by:
   British Columbia Life & Casualty Company (“BC Life”)
                     (GROUP 903404)
        PAYMENT                              MAXIMUM                  MAXIMUM
                                             PAYMENT                   PERIOD
         Flat benefit                          $447                    50 weeks*
                  (*7 weeks BC Life, 15 weeks EI, 28 weeks BC Life)




Revised: March 10, 2009              Pile Drivers –PIWDbook Elig p            Page 11 of 19
              LONG TERM DISABILITY (LTD)
                          Insured by:
     The Great West Life Assurance Company (“Great West
                             Life”)
                       (GROUP 161747)
       PAYMENT                           MAXIMUM                   MAXIMUM
                                         PAYMENT                    PERIOD
Two-thirds of average pre-                 $2,000                    Age 60
  disability earnings*
   (*reduced by WCB and auto insurance, subject to 80% overall maximum)
             MEDICAL SERVICES PLAN (MSP-BC)
                      (Group 3134046)
BC Provincial Government Basic Medical
Plan Pays Premium for active (non-retired) members and eligible retirees
only, subject to enrollment. Premiums paid by the Plan are a taxable
benefit.

               EXTENDED HEALTH CARE (EHC)
                          and DENTAL
              Insured by: Pacific Blue Cross (“PBC”)
             (GROUP E903404, D903404 and E903604)
          EHC                            PAYMENT                   MAXIMUM
         (Active)                   80% Reimbursement,              $1,000,000*
                                    after $50 Deductible,             lifetime
         (Retired)                  80% Reimbursement,               $25,000*
                                    after $50 Deductible,          per 24 months

   Dental (Active only)                  PAYMENT                    MAXIMUM
       Part A (Basic)                      90%                        No limit*
 Part B (Crown & Bridge)                   60%                        No limit*
     Part B (Dentures)                     90%                        No limit*
   Part C (Orthodontia)                    50%                     $4,000 lifetime
   (*see the Benefits Booklets for exclusions, and limits on specific services)
                  DIVERS’ MEDICAL EXAMINATIONS
                       Self-Insured by the Trust
 The cost of Divers’ Medical examinations is covered through separate
              funding in the Divers’ collective agreement.




Revised: March 10, 2009       Pile Drivers –PIWDbook Elig p             Page 13 of 19
… for benefits not described in the Benefits
Booklets

MEMBER ASSISTANCE PROGRAM
The Member Assistance Program (MAP) benefit provides assessment,
referral, and short-term counseling services to members of Pile Drivers,
Divers, Bridge, Dock & Wharf Builders Local 2404 and their families
who are experiencing problems in their personal, family, or work lives.
This includes problems such as relationship and marital difficulties,
separation and divorce, parenting issues, depression, anxiety, and
stress, addictions and substance abuse, problem gambling, child- and
eldercare issues, and work-related concerns. The MAP benefit is
available to members in good standing of Local 2404 whether Union
Status is Active or Retired, and their spouses and dependent children.
Local 2404’s MAP is provided by Family Services Employee
Assistance Programs (FSEAP), one of Canada’s largest MAP
providers.
As part of your MAP benefit, you and each covered member of your
family are eligible to receive short-term, solution-focused counseling as
determined by your clinical issues and needs. If you or members of
your family need or desire additional counseling beyond that provided
by the MAP, you may continue to see your MAP counselor on a fee-
for-service basis, using your extended health benefits to help pay for
the cost of this counseling, up to the annual plan limits (See “In
Province Eligible Expenses” under Extended Health Care in the
Benefits Booklets.)
Participation in the MAP is completely confidential. No information is
disclosed by the MAP regarding an individual’s participation in it
absent a signed written release, or in circumstances involving an
imminent risk of physical harm, child or elder-abuse, or where ordered
by a court of law.
If you wish to access the MAP, please contact FSEAP at 604-732-6933
or 1-800-667-0993. Services for emergencies are provided 24 hours a
day, 365 days a year.


Revised: March 10, 2009        Pile Drivers –PIWDbook Elig p                Page 15 of 19
BASIC MEDICAL
When you qualify you will be covered with the Medical Services Plan
of BC (MSP-BC) provided you have completed the required
application form. Your group MSP No. is 3134046.
Every British Columbian should be covered for MSP-BC once and only
once. If you are covered by your spouse and wish to stay covered that
way, please contact the Plan Office to file an “Opt Out” notice.

DIVERS’ MEDICAL EXAMINATIONS
Under the Divers 1996 and subsequent Collective Agreements, diving
contractors remit an additional 33 cents on straight time, reducing to 25
cents effective May 1, 2008. The Trustees used this to establish a
separate fund, which pays for the regular medical examinations
required by WCB to measure how much the pressure is affecting them.
Claims
Send your receipts to the Plan Office for processing. If you are
eligible*, and there is a proper receipt for each necessary procedure,
you will be reimbursed by the Plan following the next month-end
processing.
*        At their meeting held September 15, 2000, the Trustees
         determined that all members in good standing of Local 2404
         are eligible for reimbursement of divers medical examination
         costs.




“REASONABLE AND CUSTOMARY”
As noted in the Benefits Booklets, PBC does not recognize excluding
“Any amount of fees in excess of the usual or recognized fees for the
services performed.” In other words, PBC applies “reasonable and
customary” (R&C) limits to many goods and services.
For some services, such as paramedical practitioners, you can find
PBC’s R&C limits on their web site. However, some services are more
specialized, and PBC does not publish its limits.
There are several reasons for this, including
      Limits change from time to time.
      Limits depend on the specifics of each case - using the current
                                                          s
      example, there might be a reason why one member' orthotics need
                                         s      s
      to cost more than another member' - that' certainly true of
      eyeglasses. On the other hand, paramedical charges are more
      standardized.
      If PBC published a "ceiling" price for everything, sooner or later
      everyone selling it would know what that was, and make sure they
      charged at least that much.



What can I do?
Your options, essentially, are
1) Shop around, as you would for anything else, and find out if prices
   vary.
2) Before agreeing to a large medical expense, ask PBC whether they
   consider the proposed fee within Reasonable and Customary
   limits. This is much like what happens when you get pre-approval
   before major dental work.




Revised: March 10, 2009          Pile Drivers –PIWDbook Elig p             Page 17 of 19
 If, after studying this booklet and the benefit explanations in the
Benefits Booklets provided by the insurance carriers, you have any
 questions regarding your plan please contact the Plan Office by
                  mail, telephone, fax, or Email at:

PILEDRIVERS’, DIVERS’ & BRIDGEMEN’S HEALTH &
                 BENEFIT PLAN
           c/o PACIFIC BLUE CROSS
               P.O. Box 24715, Stn-F
              Vancouver, BC V5N 5T8

                 Telephone: (604) 419-2475
                    Fax: (604) 419-2884
               Email: admn@pac.bluecross.ca
             Web page: http://pd2404.planoffice.ca/

 STREET ADDRESS FOR PERSONAL ATTENDANCE OR
                COURIER ONLY
             PACIFIC BLUE CROSS
                4250 Canada Way
             Burnaby, BC V5G 4W6

To book an appointment under the Member Assistance
                 Program, contact:

                       FAMILY SERVICES
                    #300 – 1665 West Broadway
                      Vancouver BC V6J 1X1
                     Toll Free: 1-800-667-0993
                     Telephone: 604 732-6933
                         Fax: 604 739-4353
         Email: employeeassistancegroup@fsgv.ca
                    www.fseap.bc.ca
Revised: March 10, 2009   Pile Drivers –PIWDbook Elig p   Page 19 of 19

				
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