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AMENDMENT 2009-4

AMENDMENT 2009-4
TO ITPE HEALTH & WELFARE SUMMARY PLAN DESCRIPTION


Effective January 1, 2009, Paragraph 37 of that portion of the ITPE Health & Welfare shall be Fund Summary Plan Description entitled "GENERAL EXCLUSIONS AND LIMITATIONS" shall be amended by the deletion of the second sentence, as struck through below:

"37. Services paid under Medicare or which would have been paid if the Participant had applied for Medicare and claimed Medicare benefits. With respect to end-stage renal disease (ESRD), Medicare shall be treated as the primary payer whether or not the Participant has enrolled in Medicare Part B."
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