Wellness Expense Benefit (Employee and Spouse Only)

The Plan covers a variety of wellness expenses for you and your spouse up to the limits provided in the Schedule of Benefits.

Every two calendar years, the Fund will pay wellness benefits up to the amount listed in the Schedule of Benefits for you and your spouse. These benefits include:

• Physical examinations,

• Blood tests,
  
  
• Pap Smears,
  
  
• X-rays,
  
  
• Mammograms,
  
  
• EKGs,
  
  
• Smoking cessation programs, and
  
  
• Other routine services and covered supplies that contribute to maintaining your wellness, if approved in advance by the Fund Office, and are not covered elsewhere under the Plan. A request for such pre-approval constitutes a pre-service claim. See the Pre-service Claims section.

You do not need to pay a deductible or copayment for these benefits and you may use either PPO or non-PPO healthcare Providers.

Wellness benefits are provided only for you and your spouse and are not provided for your Dependent Children. However, Inpatient nursery charges, routine Physician examinations and routine immunizations are covered under the Comprehensive Major Medical Benefit for your eligible Dependent Children up to the age of 23. See Covered Expenses

Please note that wellness benefits will only be paid when your Physician uses a diagnosis code that qualifies for reimbursement under the Fund. For more information, please contact the Fund Office.