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TCSI VAO N HEAL A N N UIYTHATION PENHow You Can Reach UsAt the Fund Office, we welcome your questions orrequests for information. There are a number ofways to reach us.WINTER 2010/2011VOLUME 5 ISSUE 1DROP IN. We’re located on the third floor at417 Fifth Avenue, between 37th and 38th Streets.CALL US. In New York, the number is 212-580-9092.The toll-free number is 1-800-456-FUND (3863).from the executive directorSEND US A FAX.the passing of the comprehensive national health care reform known as theAs 2010 draws to a close, we look back on a busy year—particularly withOur main fax number212-787-3607Affordable Care Act. Since President Obama signed it into law in March,Benefits212-730-7706federal agencies have been issuing detailed regulations that clarify how theContracts & Contributions212-792-8322new law will impact our Health & Welfare Plans. While many of the newFinance212-792-8321rules won’t take effect for several years, a few will become effective for bothPension212-792-8323Plan A and Plan C as soon as we turn the page on the new year.Executive Director212-792-8320EMAIL US via our Web site (www.iatsenbf.org).One of the first changes to take effect is the extension of benefits to childrenup to age 26. This applies to all children, regardless of where they livePlease note that the Fund Office will be closed inobservance of the following holidays:and whether or not they are students, married or financially dependent onChristmas EveFriday, December 24enrollment statement and proof of relationship (e.g., birth certificate,New Year’s DayFriday, December 31adoption papers) to reenroll any dependent under age 26 for coverageMartin Luther King DayMonday, January 17beginning January 1, 2011.President’s Dayyou. Remember, you have until December 15, 2010, to submit your annualMonday, February 21In addition, a couple of Plan provisions that limit benefits are beingGetting Better All the TimeWe continually update and enhanceour Web site. If you log on towww.iatsenbf.org, you can makePlan C self-payments, change youraddress, monitor employercontributions, review plan informationand link to service vendors tofind a doctor. You can even connectto Prudential to check on yourretirement savings. Local unionsalso now have access to a separateportal to view and request reportsabout work in their area. Have abenefits question? Try the Web site.You may be surprised byhow quickly and easilyyou can find the answer.eliminated in 2011. First, the 1 million cap on out-of-network lifetimebenefits under Plan A and Plan C will go away. Starting next year, lifetimebenefits for all covered services will be unlimited—whether you use inor out-of-network providers. (However, certain annual limits will apply until2014.) In addition, if you’re enrolled in Plan C-3, there’s more good news.The 2,000 limit on how much the Plan pays each year for prescriptiondrugs is being eliminated.For other good news, turn to page 2 of this issue of Behind the Scenes.You’ll see that we expect to pretty much hold the line on CAPP charges forHealth & Welfare Plan C through at least the third quarter of 2011.As we remind all participants this time each year, please read all notices thatyou receive from the Fund. The more you know, the better you can manageyour accounts and take advantage of your benefits. Of course, if you havequestions, you can contact the Fund Office by email, phone or fax.Happy holidays from all of us at the Fund Office. We wish you a healthy andprosperous new year.Anne J. Zeisler

HEALTH & WELFAREANNUALENROLLMENT 2011Plan C Annual Enrollment2011 is underway, andyou have until December 15to review your optionsfor coverage in 2011.If you haven’t received yourenrollment materials,contact the Fund Officeimmediately. All paymentsand/or changes for Januarymust be received by theFund Office no later thanDecember 15, 2010.Boomers Listen Up!Plan A and C both provide retiree health benefitsto eligible participants. If you’re eligible, youmust request and complete an application.If you’re enrolled in retiree coverage underPlan C and you return to work for anemployer that contributes to theHealth & Welfare Fund, your retireecoverage will end if employercontributions made on your behalfequal at least one quarter of PlanC-3 single coverage. If you're in Plan A,your retiree benefits will end if youwork at least 60 days in coveredemployment over six consecutive months.WeApologize If your retiree coverage ends, you will have tofile a new application to restart it.if the newHealth &NALNATIO ELFAREWWelfare FundCTH &HEAL ND PLANFUPlan C SummaryPlan Description(SPD) was crammedinto your mailbox.We combined two bookletsinto one for easierreference. So now you haveall the information youneed in one place. We evenincluded a pocket in theback for rate letters andother important informationyou receive from theFund Office.On Medicare? Plan C-MRPMay Not Be an OptionIf you are in Plan C and permanently stopworking in covered employment (retire) afteryou become eligible for Medicare, Medicarewill become your primary source of healthinsurance. In this situation, because Medicarequalifies as “other coverage,” you are allowedto enroll in the Medical Reimbursement Program(Plan C-MRP) on a standalone basis. What’smore, unlike other Plan C-MRP participants,you are not required to submit proof of othercoverage each year. However, the 150 annualadministrative fee still applies.CAPP RatesHold SteadyDespite continuingincreases nationwidein medical, hospitaland prescription drugcosts, CAPP chargesfor Plans C-1 and C-3are not changing—at least through mostof 2011. Plan C-2charges will increaseby 45 for individualand family coveragestarting April 1.2However, if you continue to work (or return towork) after you become Medicare eligible,you may lose your eligibility for Plan C-MRP.That’s because, under federal law, Medicarecannot be your primary source of healthinsurance if insurance is available through youremployer or an employer-sponsored plan likeours. You lose your eligibility for Plan C-MRPduring a coverage quarter if: employer contributions were made to yourCAPP account during the three monthsknown as the contribution test period, andyour CAPP account balance is sufficient tocover the cost for one quarter of Plan C-3single coverage.If you are Medicare-eligible, the Fund tests youreligibility for Plan C-MRP each quarter. Yourchoices for coverage each quarter will depend onthe results of the test. If you lose your eligibilityfor Plan C-MRP and fail to elect another PlanC option, you will be enrolled automaticallyin Plan C-3 single coverage. Be sure to reviewyour statement each quarter to make sure youunderstand your options.Plan C-MRP without MedicareIf you are enrolled in Plan C-MRP, you mustprovide valid proof each year between mid-Novemberand December 15 that you have other medicalcoverage along with your Annual Enrollmentstatement. If you do not, you will be enrolledautomatically for individual coverage in Plan C-2or C-3 (depending on your CAPP accountbalance) and a 150 administrative fee will bededucted from your account. If there’s not enoughfunding in your CAPP account for Plan C-3individual coverage, you will not have anycoverage under Plan C.2011 QUARTERLY CAPP COST TO YOUEffectiveJanuary 1, 2011EffectiveApril 1, 2011EffectiveJuly 1, 2011Plan C-1IndividualFamily3,549 (no change)7,770 (no change) 3,549 (no change) 7,770 (no change) 3,549 (no change) 7,770 (no change)Plan C-2IndividualFamily 1,542 (no change) 2,598 (no change) 1,587 2,643 1,587 (no change) 2,643 (no change)Plan C-3IndividualFamily 1,086 (no change) 2,058 (no change) 1,086 (no change) 2,058 (no change) 1,086 (no change) 2,058 (no change)

VACATIONImportant RemindersYou have certain rights as a participant in PlanC that are protected by law. Here is a reminderof 1. your right to privacy with respect to healthinformation, 2. a woman’s rights related toa mastectomy and 3. a student child's right toextended coverage in the event of a medicalleave of absence.1. PrivacyThe Health Insurance Portability andAccountability Act of 1996 (HIPAA)established standards to guarantee the privacyof personal health information. The intent ofHIPAA is to make sure that private healthinformation that identifies (or could be used toidentify) you is kept private. This individuallyidentifiable health information is known as“protected health information” (PHI). Yourhealth care plans will not use or disclose yourprotected health information without yourwritten authorization except as necessary fortreatment, payment, plan operations and planadministration, or as permitted or required bylaw. For details about the IATSE NationalHealth & Welfare Fund’s policy, you can findour Privacy Notice on our Web site atwww.iatsenbf.org, or you can request a copyfrom the Fund Office.2. Protections for Mastectomy PatientsThe Women’s Health and Cancer Rights Act of1988 (WHCRA) includes importantprotections for mastectomy patients who electbreast reconstruction in connection with amastectomy. Under WHCRA, group healthplans offering mastectomy coverage must alsoprovide coverage for certain services relating tothe mastectomy in a manner determined inconsultation with the attending physician andthe patient. Required coverage includes allstages of reconstruction of the breast on whichthe mastectomy was performed, surgery andreconstruction of the other breast to producea symmetrical appearance, prostheses andtreatment of physical complications of themastectomy, including lymphedema. Coverageof breast reconstruction is subject to the samecoinsurance and other plan provisions asother benefits under the plan.3. Dependent Children in SchoolIf a dependent child enrolled in Health &Welfare Plan A or Plan C is on a medicallynecessary leave of absence from a postsecondaryschool, coverage may be continued under thePlan for up to one year.In order to be eligible for this extension ofcoverage, the Plan must be provided with awritten certification from the child’s treatingphysician that: Check In for Time OffSince the work you’reperforming now in 2010 countstoward the vacation benefitcheck you’ll receive next May,it’s a good idea to make sureyour time is being reportedcorrectly. Simply log on to ourWeb site (www.iatsenbf.org)and check your work history.And, if you haven’t alreadysigned up for direct depositfor your vacationbenefit check, youcan downloada form thatauthorizes theFund to send yourbenefit check directly to yourbank account. You’ll needto provide your bank name,account number and bankrouting number.the child is suffering from a serious illness orinjury, andthe leave of absence from the postsecondaryinstitution is medically necessary.Coverage may continue for up to one year fromthe first day of the medically necessary leaveunless the dependent child would otherwise losecoverage (e.g., because he or she reaches age 25).If you have any questions about any ofyour rights, contact the Fund Office.Just for FunSee if you can match the song with the movie in which it was performed.Answers appear below.1. Baby It’s Cold OutsideA. The Lemon Drop Kid3. Silver BellsC. The Muppet Christmas Carol2. Somewhere in My Memory4. One More Sleep ‘Til Christmas5. What’s This?6. All I Want For Christmas Is YouB. Love ActuallyD. ElfE. Home AloneF. The Nightmare Before Christmas1.D 2.E 3.A 4.C 5.F 6.B3