September 9, 2010 Provision whereby the Fund will reimburse Medicare part B premium of any active participant for whom Medicare is primary AMENDMENT The Trustees have the authority under Section 3.02 and Section 6.01 of the St. Louis Graphic Arts Joint Health & Welfare Fund Trust Agreement of August 1, 1979, to amend the Plan. Under this authority, the Trustees amend the Summary Plan Description of November 1, 2006 to add a provision whereby the Fund will reimburse Medicare part B premium of any active participant for whom Medicare is primary. AMENDMENT Section 9.7, setting out the rules for the Medicare Coordination of Benefits is amended as follows: 9.7 Medicare Coordination of Benefits If this Plan is secondary to Medicare (i.e., Medicare determines its benefits before this Plan does): 1. You and your Dependents must enroll for Part B of Medicare. If you do not enroll for Part B of Medicare your benefits and those of your Dependents who are eligible but not enrolled for Part B will be reduced by the amount of Medicare benefits which would have been payable had you enrolled for Part B of Medicare. 2. Effective November 1, 2008, the Fund will reimburse the Part B premium for you and your dependents: • If you are an Active Employee; and • If Medicare is primary. 3. This Plan does not cover services which are not covered by Medicare because a Covered Individual and his health care provider have entered into a "private contract" (under the Balanced Budget Act of 1997 or otherwise) which exempts the services from Medicare, its regulations and its price controls. If you are an active Employee of an employer with 20 or more Employees or the spouse of such an Employee and are covered by Medicare for reasons other than kidney dialysis or end stage renal disease, this Medicare Coordination of Benefits provision does not apply to you. This Plan will pay its regular medical benefits for you. If you are also enrolled in Medicare, it may supplement the benefits you receive under this Plan. The Fund will not reimburse the part B premium for retired participants or for individuals where the Fund is primary to Medicare. If you are covered by Medicare due to kidney dialysis or end stage renal disease, this Plan will pay its regular medical benefits for you during the first 30 months you are covered by Medicare. Thereafter, Medicare will be your primary coverage, and the benefits payable under this Plan will be reduced so that the combined benefits do not exceed the expense actually incurred. If Medicare is the primary payor, you must submit copies of Medicare's explanation of payments and itemized bills to the claims administrator.   St. Louis Graphic Arts Joint Health & Welfare Fund 14323 South Outer Forty Rd. - Suite S106 Chesterfield, Missouri 63017 Fund Office: (314) 878-1579 twesthues@slgahw.org Fax: (314) 275-2640   If you have any comments about this web site, please contact us at twesthues@slgahw.org.   Site Concept and Design ©2002 jWeb. Maintenance and Hosting provided by jWeb.