Grandfather Status

Effective July 1, 2012, the Trustees of the ITPE Health & Welfare Plan believe that this Plan is no longer a “Grandfathered Health Plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act).  Accordingly, effective July 1, 2012, the Plan will provide the preventive health services mandated by the Affordable Care Act without any cost sharing by Participants.  In addition, effective July 1, 2012, the Plan shall afford Participants an “External Appeal” process as a voluntary final step in connection with the review of denials of medical claims.

A description of the preventive health services provided by the Plan without any cost sharing as of July 1, 2012 is set forth in the Summary Plan Description, and at Section 9.03(c) of the ITPE Health & Welfare Plan.

Questions regarding which protections apply and which protections do not apply to a Grandfathered Health Plan and what might cause a plan to change from Grandfathered health plan status can be directed to the Plan Administrator by calling 1-800-327-5926 or 1-912-352-7169, or writing to Board of Trustees, ITPE Health & Welfare Fund, Attention Plan Administrator, P.O. Box 13817, Savannah, GA  31416.  You may also contact the Employee Benefit Security Administration, at U.S. Department of Labor at 1-866-444-3272 or www.dol.gov\ebsa\healthreform.This website has a table summarizing which protections do and do not apply to Grandfathered Health Plans.