Health and Welfare - Self-funded PPO Benefits FAQs

• Does the Plan limit benefits for a pre-existing condition?

  No, this Plan does not have a pre-existing condition clause. A pre-existing condition is one in which the onset of symptoms or treatment occurs before the participant is eligible for coverage under the Plan.

  Although this Plan has never limited benefits for pre-existing conditions, the Health Insurance Portability and Accountability Act (HIPAA) either reduces or eliminates the period in which any group plan can apply pre-existing limitation rules. For instance, if your coverage terminates and your new group plan has a pre-existing condition clause, the 12 or 18-month period in which they can apply the exclusion, will be reduced (or eliminated) by the length of time you had coverage in the San Francisco Electrical Workers Plan. When your coverage terminates, you will receive a Creditable Coverage Certificate that you can provide to your new group plan for this purpose if necessary.