multi-employer plans - centers for medicare & medicaid services
TRANSCRIPT
Multi-Employer Plans: Approved Applications for Waiver of the Annual Limits Requirements
January 6, 2012 These plans are multi-employer group health plans created by a collective bargaining agreement between a union and employers, under the Taft Hartley Act. This type of fund is made up of contributions from both the employers and employees. The size of the fund and contribution levels are negotiated and vary among plans. They tend to be larger than other typical group health plans because they cover multiple employers. Both the union and the employer are trustees or managers of the fund. The fund is used for the employees’ health coverage. On September 3, 2010 the Centers for Medicare & Medicaid Services (CMS) announced the initial waiver process, allowing plans to receive a one year waiver for plan or policy years with a start date between September 23, 2010 and September 23, 2011.
On June 17, 2011, the Centers for Medicare & Medicaid Services (CMS) issued subsequent guidance to conclude the annual limits waiver process. This guidance allowed plans that received one year waivers to extend those waivers through 2013, contingent on applicants submitting annual information about their plan and complying with requirements to ensure that their enrollees understand the limits of their coverage. The June 17, 2011 guidance also allowed any plans that had not yet applied for a waiver under the initial waiver policy to apply for one, good through 2013. All applications were due September 22, 2011.
The June 17, 2011 guidance leaves three categories of plans that applied for and received waivers:
1. Plans that received a one year waiver under the initial policy that also received an extension under the June 17, 2011 policy.
2. Plans that received a one year waiver under the initial policy that did not apply for an extension under the June 17, 2011 policy.
3. Plans that did not apply for a one year waiver under the initial policy but did apply for, and receive one, good through 2013, under the June 17, 2011 policy.
To capture these three categories, the list below is separated into two sections.
Section A includes every plan that received a one year waiver under the initial policy. Plans without an asterisk applied for, and received, an extension (category 1 from above). Plans with an asterisk did not apply for an extension (category 2 from above).
Section B lists plans that did not apply for a one year waiver under the initial policy but did apply for, and received, a waiver good through 2013. (category 3 from above).
Section A: Section A includes every plan that received a one year waiver under the initial policy. Plans with an asterisk did not apply for an extension. Plans without an asterisk applied for, and received, an extension. Plans must submit annual information about their plan and comply with requirements to ensure that their enrollees understand the limits of their coverage.
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
1 Maritime Association - ILA Houston TX 9/17/2010 10/1/2010 600 9/22/2010 9/24/2010
2 Metropolitan D.C. Paving Industry Employees Health and Welfare Fund Beltsville MD 9/20/2010 10/1/2010 550 9/20/2010 9/24/2010
3 Allied Industries Health Fund Montville NJ 9/13/2010 10/1/2010 127 9/13/2010 9/27/2010 4 I.U.P.A.T District Council No. 51 9/16/2010 10/1/2010 875 9/23/2010 9/27/2010
5 Transport Workers Union Health and Welfare Fund Baltimore MD 9/20/2010 10/1/2010 107 9/23/2010 9/27/2010
6 Greater Metropolitan Hotel Bloomington MN 9/16/2010 10/1/2010 1,200 9/22/2010 9/30/2010 7 Local 17 Hospitality Benefit Fund Bloomington MN 9/16/2010 10/1/2010 881 9/22/2010 9/30/2010 8 Local 802 Musicians Health Fund New York NY 9/29/2010 10/1/2010 1,801 9/29/2010 10/1/2010 9 Local 25 SEIU Chicago IL 9/29/2010 10/1/2010 31,000 10/7/2010 10/14/2010
10 Masland Carpets, LLC Bargaining Unit Health Care Plan Dalton GA 8/27/2010 1/1/2011 269 10/12/2010 10/14/2010
11 UFCW Maximus Local 455 Englewood NJ 10/4/2010 1/1/2011 59 10/4/2010 10/18/2010 12 Alaska Seafood Processors Portland OR 9/23/2010 1/1/2011 262 10/15/2010 10/21/2010
13 Asbestos Workers Local 53 Welfare Fund Kenner LA 9/29/2010 1/1/2011 510 10/21/2010 10/26/2010
14 Employees Security Fund Flushing NY 9/29/2010 1/1/2011 6,800 9/29/2010 10/26/2010
15 Florida Trowel Trades West Palm Beach FL 9/27/2010 1/1/2011 297 10/21/2010 10/26/2010
16 Meijer Health Benefits Plan/Extended Care Option Grand Rapids MI 10/1/2010 1/1/2011 4,873 10/5/2010 10/26/2010
17 Plumbers & Pipefitters Local 123 Welfare Fund Jacksonville FL 9/30/2010 1/1/2011 534 10/21/2010 10/26/2010
18
United Food and Commercial Workers Union Local 227 and Employers Health and Welfare Plan Louisville KY 10/12/2010 11/1/2010 1,125 10/12/2010 10/26/2010
19 IBEW No. 915 Tampa FL 9/28/2010 1/1/2011 930 9/29/2010 10/28/2010
20 New England Health Care Employees Welfare Fund Hartford CT 9/27/2010 1/1/2011 7,454 10/15/2010 10/28/2010
21
Laborers' International Union of North America (LIUNA) Local Union No. 616 Health and Welfare Plan Mount Laurel NJ 10/19/2010 1/1/2011 188 10/19/2010 10/29/2010
22 Service Employees Benefit Fund Syracuse NY 10/12/2010 11/1/2010 1,297 10/29/2010 10/29/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
23 UFCW Allied Trades Health and Welfare Trust Fund Buena Park CA 10/5/2010 12/1/2010 68 10/25/2010 10/29/2010
24
United Food and Commercial Workers Union Local 1995 and Employers Health and Welfare Trust Fund Atlanta GA 10/12/2010 11/1/2010 2,779 10/27/2010 10/29/2010
25
United Food and Commercial Workers and Participating Employers Interstate Health and Welfare Fund
East Providence RI 10/15/2010 5/1/2011 9,780 10/28/2010 11/4/2010
26 1199 SEIU Greater New York Benefit Fund New York NY 10/8/2010 1/1/2011 4,544 10/8/2010 11/5/2010
27 DC Cement Masons Welfare Fund Columbia MD 10/22/2010 11/1/2010 225 11/3/2010 11/5/2010
28 Laundry and Dry Cleaning Workers Local No. 52
City of Industry CA 10/6/2010 1/1/2011 1,547 10/21/2010 11/5/2010
29
United Food and Commercial Workers Local 1459 and Contributing Employers Health and Welfare Fund Springfield MA 10/14/2010 1/1/2011 1,400 10/14/2010 11/5/2010
30 United Food and Commercial Workers Union (Mount Laurel NJ) Mount Laurel NJ 10/21/2010 11/1/2010 4,100 10/21/2010 11/8/2010
31 Alaska Pipe Trades U.A. Local 367 Health and Security Trust Anchorage AK 10/8/2010 1/1/2011 93 11/5/2010 11/15/2010
32 Amalgamated National Health Fund White Plains NY 10/8/2010 1/1/2011 24,739 11/9/2010 11/15/2010 33 Cleveland Bakers Teamsters Valley View OH 10/25/2010 1/1/2011 1,000 10/29/2010 11/15/2010 34 Indiana Teamsters Health Benefits Fund Indianapolis IN 9/29/2010 1/1/2011 500 11/1/2010 11/15/2010 35 NOITU Insurance Trust Fund Jamaica NY 10/5/2010 1/1/2011 1,390 11/12/2010 11/15/2010
36 Plumbers and Pipefitters Local No. 630 Welfare Fund
West Palm Beach FL 10/18/2010 1/1/2011 1,166 11/8/2010 11/15/2010
37 The UFCW Local 1000 Oklahoma Health and Welfare Fund
Pembroke Pines FL 10/26/2010 1/1/2011 3,855 11/12/2010 11/15/2010
38 United Wire Metal and Machine Health and Welfare Fund
Long Island City NY 10/1/2010 1/1/2011 1,955 11/1/2010 11/15/2010
39
Wisconsin United Food & Commercial Workers Unions and Employers Health Plan Chicago WI 10/14/2010 12/1/2010 775 10/14/2010 11/15/2010
40 Bricklayers Local 1 of MD VA and DC Oxon Hill MD 11/6/2010 1/1/2011 1,985 11/17/2010 11/23/2010
41 Greater Kansas City Laborers Welfare Fund
Overland Park KS 10/21/2010 11/1/2010 2,398 10/21/2010 11/23/2010
42 International Brotherhood of Trade Unions Health and Welfare Fund - Local Garden City NY 10/28/2010 1/1/2011 1,132 11/15/2010 11/23/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
713
43 Local 1102 Amalgamated Welfare Fund Westbury NY 10/29/2010 1/1/2011 1,384 10/29/2010 11/23/2010 44 Local 1102 Health & Benefit Fund Westbury NY 10/29/2010 1/1/2011 4,907 10/29/2010 11/23/2010
45 Local 1102 Welfare Fund (Lerner Employees) Westbury NY 10/29/2010 1/1/2011 245 10/29/2010 11/23/2010
46 Local 338 Affiliated Benefit Funds Mineola NY 11/19/2010 1/1/2011 18,209 11/19/2010 11/23/2010 47 Local 348 Health & Welfare Fund Brooklyn NY 10/29/2010 1/1/2011 13,663 10/29/2010 11/23/2010
48
Local 371 United Food and Commercial Workers Amalgamated Welfare Trust Fund Westport CT 11/2/2010 1/1/2011 3,800 11/2/2010 11/23/2010
49 Operating Engineers Local 835 Health and Welfare Fund Abington PA 10/20/2010 1/1/2011 576 11/16/2010 11/23/2010
50 Retail, Wholesale & Dept. Store Union Local 1034 Welfare Fund Abington PA 10/20/2010 1/1/2011 483 11/16/2010 11/23/2010
51 SEIU Local 1 Cleveland Welfare Fund Cleveland OH 10/20/2010 1/1/2011 520 11/15/2010 11/23/2010 52 SMWIA Local 28 Welfare Fund Mineola NY 11/1/2010 1/1/2011 6,517 11/1/2010 11/23/2010
53 Southern California Pipe Trades Trust Fund Los Angeles CA 10/12/2010 1/1/2011 12,700 11/2/2010 11/23/2010
54 Texas Carpenters and Millwrights Health and Welfare Fund 10/28/2010 1/1/2011 4,729 10/28/2010 11/23/2010
55 United Crafts Benefits Fund Williston Park NY 11/1/2010 1/1/2011 2,017 11/1/2010 11/23/2010
56 United Food and Commercial Workers Local 1445 New Hampshire Quincy MA 10/27/2010 1/1/2011 148 11/9/2010 11/23/2010
57 Local 272 Welfare Fund New York NY 10/28/2010 12/1/2010 12,000 10/28/2010 12/1/2010 58 Local 298 Health Benefit Fund Plan Valley Stream NY 10/29/2010 1/1/2011 273 10/29/2010 12/1/2010 59 Southwestern Teamsters Security Fund Phoenix AZ 10/29/2010 12/1/2010 589 11/23/2010 12/1/2010
60 Teamsters Local 210 Affiliated Health and Insurance Fund Staten Island NY 11/15/2010 1/1/2011 10,613 11/15/2010 12/1/2010
61 Teamsters Local 445 Welfare Plan Newburgh NY 11/1/2010 1/1/2011 575 11/29/2010 12/1/2010
62 UNITE HERE Local 74 Welfare and Dental Trust Bridgeton MO 11/12/2010 1/1/2011 220 11/29/2010 12/1/2010
63 United Employees Health Plans Westbury NY 11/15/2010 1/1/2011 1,073 11/15/2010 12/1/2010
64
United Food & Commerical Workers Union Local No. 911 and Employers' Health & Welfare Trust Fund Cleveland OH 11/19/2010 1/1/2011 582 11/19/2010 12/1/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
65
United Food and Commercial Workers Union Local 1000 and Kroger Dallas Health and Welfare Plan
Pembroke Pines FL 10/26/2010 1/1/2011 7,389 11/30/2010 12/1/2010
66 IBEW Local 613 and Contributing Employers Family Health Plan (Union) Tucker GA 10/28/2010 1/1/2011 8,500 11/17/2010 12/3/2010
67 Blasters Drillers & Miners Union Local No. 29 Welfare Fund Astoria NY 11/4/2010 1/1/2011 1,000 11/29/2010 12/6/2010
68 Cement and Concrete Workers District Council Welfare Fund Plan Flushing NY 10/25/2010 1/1/2011 3,498 11/19/2010 12/6/2010
69 Construction Workers Local 147 Welfare Fund Jersey City NJ 11/15/2010 1/1/2011 2,000 11/26/2010 12/6/2010
70 International Union of Bricklayers & Allied Craftworkers Washington DC 10/21/2010 1/1/2011 3,758 11/19/2010 12/6/2010
71
Landscape, Irrigation and Lawn Sprinkler Industry Health and Welfare Plan and Trust Los Angeles CA 11/4/2010 1/1/2011 210 11/22/2010 12/6/2010
72 Local 803 Health and Welfare Fund New York NY 10/25/2010 11/1/2010 101 11/16/2010 12/6/2010
73 Louisiana Laborers Health and Welfare Fund Goodlettsville TN 11/8/2010 1/1/2011 4,500 11/24/2010 12/6/2010
74 Minnesota Teamsters Construction Division Minneapolis MN 10/28/2010 12/1/2010 1,248 10/28/2010 12/6/2010
75 Plumbers & Pipefitters Local Union 823 Health & Welfare Fund Harlingen TX 11/9/2010 1/1/2011 285 11/18/2010 12/6/2010
76 Plumbers & Steamfitters Local No. 6 Health and Welfare Fund 11/4/2010 1/1/2011 875 11/22/2010 12/6/2010
77 Teamsters Welfare Fund of Northern New Jersey Local 723 Union NJ 10/22/2010 1/1/2011 1,154 10/29/2010 12/6/2010
78 United Service Employees Union Local 377 Welfare Fund
Long Island City NY 11/4/2010 1/1/2011 1,142 11/10/2010 12/6/2010
79
United Food and Commercial Workers and Employers Arizona Health and Welfare Trust Phoenix AZ 11/11/2010 1/1/2011 516 11/27/2010 12/7/2010
80 Minnesota Cement Masons Health and Welfare Fund Minneapolis MN 11/2/2010 1/1/2011 2,000 11/19/2010 12/8/2010
81 Plumbers Local Union No. 690 of Philadelphia and Vicinity Health Plan Philadelphia PA 11/3/2010 1/1/2011 4,006 11/3/2010 12/8/2010
82 Sheet Metal Workers Funds of Local Union 38 Brewster NY 11/3/2010 1/1/2011 913 11/30/2010 12/9/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
83
United Food & Commercial Workers Unions and Employers Midwest Health Benefits Fund Park Ridge IL
10/21/2010 10/28/2010 12/1/2010 821 12/3/2010 12/9/2010
84
IBEW Local No. 640 and Arizona Chapter NECA Health & Welfare Trust Fund Phoenix AZ 11/24/2010 1/1/2011 261 12/8/2010
12/10/2010 12/15/2010
85
Local 464A United Food and Commercial Workers Union Welfare Service Benefit Fund Little Falls NJ 11/12/2010 1/1/2011 8,228 11/12/2010 12/10/2010
86 NECA-IBEW Local 480 Health and Welfare Plan Jackson MI 11/11/2010 1/1/2011 1,698 11/22/2010 12/10/2010
87 Plumbers and Pipefitters Welfare Fund of Local Union No. 719 Tucker GA 11/19/2010 1/1/2011 480 11/29/2010 12/10/2010
88
Theatrical Teamsters Local 817 International Brotherhood of Teamsters Welfare Fund Lake Success NY 11/29/2010 1/1/2011 487 11/29/2010 12/10/2010
89 Allied Welfare Fund Staten Island NY 11/8/2010 1/1/2011 2,523 11/8/2010 12/13/2010 90 Aerospace Contractors' Trust Goodlettsville TN 11/9/2010 1/1/2011 2,072 12/8/2010 12/14/2010
91
Amalgamated Industrial and Toy & Novelty Workers of America Local 223 Sick Benefit Fund New York NY 11/5/2010 1/1/2011 1,546 11/16/2010 12/14/2010
92 Atlanta Plumbers & Steamfitters Fringe Benefit Funds Atlanta GA 11/9/2010 1/1/2011 7,235 12/8/2010 12/14/2010
93 Central Texas Health and Benefit Trust Fund Locals 520, 60 & 72 Plano TX 11/10/2010 1/1/2011 500 12/7/2010 12/14/2010
94 Electricians Health Welfare & Pension Plans I.B.E.W. Local Union No. 995 Baton Rouge LA 11/15/2010 1/1/2011 980 12/1/2010 12/14/2010
95 Florida Laborers Health Fund Goodletsville TN 11/2/2010 1/1/2011 1,700 11/24/2010 12/14/2010 96 Louisiana Electrical Health Fund Goodlettsville TN 11/9/2010 1/1/2011 415 12/8/2010 12/14/2010 97 Memphis Construction Benefit Fund Goodlettsville TN 11/9/2010 1/1/2011 507 12/8/2010 12/14/2010
98 Mid-South Carpenters Regional Council Health and Welfare Fund Goodlettsville TN 11/9/2010 1/1/2011 5,465 12/8/2010 12/14/2010
99
Retiree Plan of the Central States, Southeast and Southwest Areas Health and Welfare Fund Rosemont IL 10/22/2010 1/1/2011 17,440 11/23/2010 12/14/2010
100 Roofers' Unions Welfare Trust Fund Des Plaines IL 11/17/2010 1/1/2011 52 12/14/2010 12/14/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
101
Sheet Metal Workers Local No. 177 Health and Welfare, Pension and Vacation Funds Goodlettsville TN 11/9/2010 1/1/2011 965 12/8/2010 12/14/2010
102 Sheet Metal Workers' National Health Fund Goodlettsville TN 11/9/2010 1/1/2011 4,500 12/8/2010 12/14/2010
103 South Central Laborers' Health & Welfare Fund Goodlettsville TN 11/9/2010 1/1/2011 330 12/8/2010 12/14/2010
104 Southeastern Pipetrades Health & Welfare Fund Goodlettsville TN 11/9/2010 1/1/2011 2,270 12/8/2010 12/14/2010
105 Southern Operators Health Fund Goodlettsville TN 11/9/2010 1/1/2011 3,415 12/8/2010 12/14/2010
106 UFCW Local 1262 and Employers Health & Welfare Fund Clifton NJ
10/21/2010 10/29/2010 12/1/2010 8,418 12/6/2010 12/14/2010
107 Electrical Welfare Trust Fund Lanham MD 11/4/2010 1/1/2011 78 12/7/2010 12/16/2010 108 Laborers Local 322 Massena NY 11/22/2010 1/1/2011 368 12/17/2010 12/17/2010
109 Man-U Service Contract Health and Welfare Fund Beltsville MD 11/30/2010 1/1/2011 946
12/1/2010 12/27/2010
12/17/2010 2/9/2011
110 Truck Drivers and Helpers Local 355 Health & Welfare Fund Baltimore MD 11/30/2010 1/1/2011 905 12/13/2010
12/17/2010 12/20/2010
111 Delmarva United Food and Commercial Workers Millsboro DE 11/12/2010 1/1/2011 2,405 12/1/2010 12/20/2010
112 IBEW Local Union No. 728 Family Healthcare Plan
Fort Lauderdale FL 11/29/2010 1/1/2011 31 12/15/2010 12/20/2010
113 Life Benefit Plan Brooklyn NY 11/17/2010 1/1/2011 3,167 12/13/2010 12/20/2010 114 SEIU Health & Welfare Fund Washington DC 11/30/2010 1/1/2011 1,620 12/13/2010 12/20/2010
115 Sports Arena Employees' Local 137 Welfare Fund Cherry Hill NJ 11/22/2010 1/1/2011 611 12/13/2010 12/20/2010
116 Hollow Metal Trust Fund New York NY 10/29/2010 1/1/2011 2,250 12/9/2010 12/21/2010
117 International Brotherhood of Electrical Workers Local 1430*
North White Plains NY 11/12/2010 1/1/2011 315 11/12/2010 12/21/2010
118 International Union of Operating Engineers Local Union No. 137
Briarcliff Manor NY 11/12/2010 1/1/2011 2,250 11/12/2010 12/21/2010
119 Michigan Conference of Teamsters Welfare Fund Detroit MI
11/12/2010 2/22/2011 4/1/2011 4,343
11/22/2010 3/22/2011
12/21/2010 3/30/2011
120 Minnesota and North Dakota Bricklayers and Allied Craftworkers Minneapolis MN 11/3/2010 1/1/2011 4,450 11/23/2010 12/21/2010
121
Board of Trustees for the Operating Engineers Local 101 Health and Welfare Fund Kansas City MO 11/30/2010 1/1/2011 4,465 12/23/2010 12/23/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
122 Carpenters Local No. 491 Health & Welfare Plan Baltimore MD 12/17/2010 1/1/2011 1,200 12/20/2010 12/23/2010
123 Central Laborers' Welfare Fund Jacksonville IL 12/2/2010 1/1/2011 1,863 12/20/2010 12/23/2010
124 Central States Southeast and Southwest Areas Health and Welfare Fund Rosemont IL 11/30/2010
4/1/2011 9/1/2011 326
12/13/2010 12/16/2010 12/23/2010
125 Contract Cleaners Service Employees Benefit Trust* St. Louis MO 11/18/2010 1/1/2011 1,772 12/13/2010
12/23/2010 12/28/2010
126 Eighth District Electrical Benefit Fund Salt Lake City UT 11/16/2010 1/1/2011 137 12/13/2010 12/23/2010
127 Electrical Workers Health and Welfare Fund Duluth MN 11/30/2010 1/1/2011 1,994 12/15/2010 12/23/2010
128 Health Care Employees/Employer Dental & Medical Trust
San Joaquin County CA 11/30/2010 1/1/2011 744 12/16/2010 12/23/2010
129 Hotel, Restaurant & Bar Employees Health and Welfare Fund Duluth MN 11/30/2010 1/1/2011 98 12/15/2010 12/23/2010
130 Northern Minnesota-Wisconsin Area Retail Food Fringe Benefits Duluth MN 11/30/2010 1/1/2011 3,100 12/17/2010 12/23/2010
131 Roofers Local No. 96 Health & Welfare Fund Bloomington MN 12/16/2010 12/1/2010 2,838 12/20/2010 12/23/2010
132 Service Employees 32BJ North Health Benefit Fund New Rochelle NY 12/1/2010 1/1/2011 7,020 12/23/2010 12/23/2010
133 Service Employees International Union Local 2000 Health & Welfare Fund St. Louis MO 12/1/2010 12/1/2010 161 12/1/2010 12/23/2010
134 Teamsters Local Union 966 Health Fund New York NY 11/30/2010 1/1/2011 1,519 12/13/2010 12/23/2010 135 American Radio Association Plans Mesa AZ 11/30/2010 1/1/2011 32 12/15/2010 12/28/2010
136 Carpenters Health and Security Trust of Western Washington Seattle WA 11/19/2010 1/1/2011 8 12/15/2010 12/28/2010
137 District Council 1707 Local 389 Home Care Employees Health & Welfare Fund New York NY 11/26/2010
3/1/2011 9/1/2011 7,867 12/22/2010 12/28/2010
138
Health and Welfare Plan of the Laundry, Dry Cleaning Workers & Allied Industries Health Fund, Workers United Newark NJ 11/16/2010 1/1/2011 4,000 12/16/2010 12/28/2010
139 Northern Illinois and Iowa Laborers Health and Welfare Fund Rock Island IL 11/30/2010 1/1/2011 133 12/16/2010 12/28/2010
140 I.B.E.W. Local 1249 Insurance Fund East Syracuse NY 11/5/2010 1/1/2011 4,104 11/5/2010 12/29/2010
141 International Brotherhood of Teamsters Local 72 Welfare Fund New York NY 11/9/2010 1/1/2011 4,650 11/9/2010 12/29/2010
142 Andersen Corporation Minneapolis MN 11/16/2010 1/1/2011 2,852 12/21/2010 12/30/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
143 Bricklayers Insurance & Welfare Fund New York NY 11/29/2010 1/1/2011 3,997 12/22/2010 12/30/2010
144 Cement Masons' Local No. 502 Welfare Fund Bellwood IL 12/16/2010 1/1/2011 450 12/28/2010 12/30/2010
145 IBEW Local Union No. 126 Health and Welfare Fund Mt. Laurel NJ 12/1/2010 1/1/2011 3,251 12/23/2010 12/30/2010
146
Indiana Area UFCW Union Locals and Retail Food Employers' Health and Welfare Plan Indianapolis IN 12/1/2010 1/1/2011 6,885 12/28/2010 12/30/2010
147 Laborers National Health and Welfare Fund Columbia MD 11/30/2010 1/1/2011 8,691 12/22/2010 12/30/2010
148 Laborers' District Council of Virginia Health and Welfare Trust Fund Roanoke VA 11/30/2010 11/1/2010 296 12/21/2010 12/30/2010
149
Local 237 Teamsters Suffolk Regional Off-Track Betting Corp. Health and Welfare Trust Fund New York NY 11/29/2010 1/1/2011 328 12/23/2010 12/30/2010
150 Local 295 Welfare Fund* Maspeth NY 12/15/2010 1/1/2011 1,228 12/22/2010 12/30/2010 151 Local 381 Group Insurance Fund Mineola NY 11/24/2010 1/1/2011 1,346 12/28/2010 12/30/2010
152 Local 805 Welfare Fund Long Island City NY 11/1/2010 2/1/2011 4,035 12/17/2010 12/30/2010
153 MO-Kan Teamsters and Welfare Fund Kansas City MO 11/29/2010 1/1/2011 1,494 12/21/2010 12/30/2010 154 Marble Industry Trust Fund New York NY 11/30/2010 1/1/2011 1,325 12/28/2010 12/30/2010
155 Pavers and Road Builders District Council Welfare Fund Flushing NY NY 11/30/2010 1/1/2011 573 12/21/2010 12/30/2010
156 Southern Graphic Communications Health Fund Jonesboro GA 11/29/2010 1/1/2011 411 12/21/2010 12/30/2010
157 Teamsters Union Local 35 Trenton NJ 11/17/2010 1/1/2011 1,109 12/27/2010 12/30/2010
158 U.A. Local 13 & Employers Group Insurance Plan Rochester NY 11/30/2010 12/1/2010 1,039 12/21/2010 12/30/2010
159 UFCW Local 1245 Health Fund Montville NJ 12/1/2010 1/1/2011 1/2/2011 3,486 12/22/2010 12/30/2010
160 UFCW Local 1500 Welfare Fund Queens Village NY 12/17/2010 1/1/2011 16,588 12/23/2010 12/30/2010
161 UFCW Local One Health Care Fund Oriskany NY 12/1/2010 1/1/2011 4,335 12/28/2010 12/30/2010
162
UFCW and Participating Food Industry Employers Tri-State Health and Welfare Fund Mt. Laurel NJ 12/1/2010 1/1/2011 2,831 12/22/2010 12/30/2010
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
163
United Union of Roofers, Waterproofers and Allied Workers Local Union No. 8 Insurance and Trust Fund New York NY 11/30/2010 1/1/2011 1,321 12/22/2010 12/30/2010
164 Wine and Liquor Salesmen of NJ Brooklyn NY 10/20/2010 1/1/2011 1,083 12/29/2010 12/30/2010 165 SPEEA, IFPTE Local 2001 Seattle, WA WA 12/21/2010 1/1/2011 73 1/4/2011 1/12/2011
166 UFCW Production Service & Sales District Council Health Fund Brooklyn NY 11/24/2010 1/1/2011 1,118 1/4/2011 1/12/2011
167 Colorado Sheet Metal Workers Local 9 Family Health Plan Lakewood CO 1/5/2011 7/1/2011 2,525 1/10/2011 1/18/2011
168
International Union of Operating Engineers Local 295-295C Welfare Trust Fund Maspeth NY 11/16/2010 1/1/2011 784 11/16/2010 1/18/2011
169 Operating Engineers Benefit Local 37 Baltimore MD 11/19/2010 1/1/2011 422 1/10/2011 1/20/2011
170 Plumbers and Pipefitters Local Union 344 Health and Welfare Plan
Oklahoma City OK 11/29/2010 1/1/2011 3,400 1/11/2011 1/20/2011
171 Production Workers Local 148 Welfare Plan Jersey City NJ 11/23/2010 3/1/2011 707
12/22/2010 3/23/2011
1/20/2011 4/1/2011
172
United Food and Commercial Workers Unions and Participating Employers Health and Welfare Fund Sparks MD
12/2/2010 1/5/2011
1/1/2011 1/11/2011 7,066
1/4/2011 2/15/2011 2/24/2011
1/20/2011 2/22/2011 2/25/2011
173 Allied Building Inspectors IUOE Local 211 Welfare Fund New York NY 11/29/2010 1/1/2011 2,720 12/23/2010 1/24/2011
174 Local 670 Welfare Fund New York NY 11/30/2010 1/1/2011 2,520 12/30/2010 1/24/2011 175 Local 7 Tile Industry Welfare Fund New York NY 11/30/2010 1/1/2011 1,632 1/3/2011 1/24/2011
176 NECA-IBEW Local 1205 Family Benefit Fund Jacksonville FL 12/3/2010 1/1/2011 678 12/29/2010 1/24/2011
177
United Food and Commercial Workers Retail Employees and Employers Health and Welfare Plan
Pembroke Pines FL 12/29/2010 1/1/2011 850 12/29/2010 1/24/2011
178 Asbestos Workers Local 21 Dallas TX 12/6/2010 1/1/2011 109 1/18/2011 1/31/2011
179 Carpenters Health & Welfare Fund of Philadelphia & Vicinity Philadelphia PA 12/15/2010 5/1/2011 20,500 1/14/2011 1/31/2011
180 Laborers Local 980 Health and Welfare Fund Roanoke VA 12/29/2010 10/1/2010 150 1/20/2011
1/31/2011 2/2/2011
181 Painters and Associated Trades Health and Welfare Trust Fund* Salt Lake City UT 12/7/2010 1/1/2011 146 1/13/2011 1/31/2011
182 Railroad Maintenance & Industrial Health and Welfare Fund Springfield IL 12/16/2010 5/1/2011 4,000 1/18/2011 1/31/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
183 Roofers & Waterproofers Local 136 Health & Welfare Fund Jonesboro GA 12/8/2010 1/1/2011 61 1/12/2011 1/31/2011
184 Teamsters Local 837 Health and Welfare Fund* Mt. Laurel NJ 12/1/2010 1/1/2011 1,016 1/14/2011 1/31/2011
185 The Great Atlantic & Pacific Tea Company, Inc. Montvale NJ 12/13/2010 1/1/2011 1,730 1/21/2011
1/31/2011 2/2/2011
186 The Welfare Fund of Plumbers Local Union #200 Ronkonkoma NY 12/2/2010 1/1/2011 1,484 1/19/2011 1/31/2011
187 UFCW Unions' and Employers' Health and Welfare Plan of Central Ohio Columbus OH 12/1/2010 1/1/2011 2,316 1/13/2011 1/31/2011
188
Amalgamated Meat Cutters & Retail Store Employees Union Local 342 Welfare Fund New York NY
12/1/2010 9/22/2011 1/1/2011 4,544
1/7/2011 1/11/2011 2/16/2011 10/11/2011
2/1/2011 2/23/2011 10/28/2011
189
Amalgamated Meat Cutters Employees Union Local 342 Great Atlantic & Pacific Tea Company H&W Fund New York NY
12/1/2010 9/22/2011 1/1/2011 1,378
1/7/2011 10/11/2011
2/1/2011 10/28/2011
190 Beverage and Brewery Drivers Local No. 67 Health and Welfare Trust Fund Oxon Hill MD 12/8/2010 3/1/2011 1,621 1/13/2011 2/1/2011
191 IAM District 15 Health Fund Brooklyn NY 11/30/2010 1/1/2011 3,213 1/14/2011 2/1/2011 192 Robert F. Kennedy Medical Plan Keene CA 12/9/2010 9/1/2011 6,565 1/11/2011 2/1/2011
193 Alabama Laborers Health and Welfare Fund Goodlettsville TN 12/22/2010 2/1/2011 1,111
1/26/2011 2/7/2011
2/7/2011 2/14/2011
194 Louisiana Carpenters Regional Council Baton Rouge LA 10/21/2010 1/1/2011 2,382 11/29/2010 2/7/2011
195 Sheet Metal #10 Benefit Fund Maplewood MN 12/16/2010 1/1/2011 6,223 12/16/2010 2/7/2011
2/7/2011 2/17/2011
196 Sheet Metal Workers' Health and Welfare Fund of North Carolina High Point NC 12/22/2010 3/1/2011 590 1/27/2011 2/7/2011
197 Shopmen's Iron Workers Health Benefit and Pension Plans Local Union 502 Limerick PA 11/22/2010 1/1/2011 701 1/10/2011 2/7/2011
198
United Food and Commerical Workers Local 400 and Employers Health and Welfare Fune Charleston WV 12/29/2010 1/1/2011 4,525 1/28/2011
2/7/2011 2/15/2011
199 Denver Grocers Health Benefit Plan Arvada CO 11/30/2010 1/1/2011 432 1/26/2011 2/9/2011
200 Plumbers and Pipefitters Local 430 Health and Welfare Fund Plano TX 11/4/2010 1/1/2011 2,035 12/8/2010 2/9/2011
201 Southern Painters Welfare Fund Metairie LA 11/19/2010 1/1/2011 2,557 12/8/2010 2/9/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
202
Westchester Putnam Counties Heavy & Highway Laborers Health & Welfare Fund, Local 60 Hawthorne NY 11/30/2010 1/1/2011 2,212 1/5/2011 2/10/2011
203 UFCW Local 152 Health and Welfare Fund Mt. Laurel NJ 12/2/2010 1/1/2011 3,094 2/3/2011
2/11/2011 2/15/2011
204 Division 1181 A.T.U. - New York Welfare Fund Ozone Park NY 12/2/2010 1/1/2011 16,000
1/12/2011 2/7/2011
2/14/2011 4/1/2011
205 Southeast Laborers Health Fund Goodlettsville TN 1/31/2011 4/1/2011 6,125 2/3/2011 2/14/2011
206 Southeastern Carpenters and Millwrights Health Trust Goodlettsville TN 1/31/2011 4/1/2011 4,500 2/3/2011 2/14/2011
207 Tazewell County, Illinois Pekin IL 12/8/2010 12/1/2010 21 1/24/2011 2/14/2011
208 Johnson & Towers, Inc. Mt Laurel NJ 12/30/2010 10/1/2010 1/1/2011 328 2/4/2011 2/15/2011
209 Local 1964 ILA Health & Insurance Plan Ridgefield Park NJ 12/16/2010 8/1/2011 771 2/10/2011 2/15/2011
210 Local 580 Benefit Funds New York NY 12/7/2010 1/1/2011 4,928 2/4/2011 2/15/2011
211 Local 99 Health & Welfare Fund Newark NJ 11/23/2010 1/1/2011 1/2/2011 920 12/17/2010 2/15/2011
212 Ohio Conference of Teamsters & Industry Health & Welfare Fund Toledo OH 1/20/2011 3/1/2011 200 2/8/2011 2/15/2011
213 Plasterers & Cement Masons Local Union No. 148 Health and Welfare Plan Jonesboro GA 1/26/2011 7/1/2011 187 2/9/2011
2/15/2011 2/16/2011
214 UFCW Local 888 Mount Vernon NY 11/30/2010 1/1/2011 4,016 1/28/2011 2/15/2011
215
United Food and Commercial Workers Unions and Employers Health and Welfare Fund Atlanta Atlanta GA 1/7/2011 4/1/2011 20,133
2/8/2011 2/23/2011
2/15/2011 2/16/2011 3/1/2011
216 Asbestos Workers Local 12 Abatement Health Fund New York NY 11/30/2010 1/1/2011 510 2/10/2011 2/16/2011
217 Employers and Operating Engineers Local No. 520 Health and Welfare Fund Swansea IL 12/6/2010 1/1/2011 3,609 1/14/2011
2/16/2011 2/17/2011
218 Local 463 Health Fund Jamaica NY 11/23/2010 11/1/2010 750 2/14/2011 2/16/2011
219 Midwest Operating Engineers Fringe Benefit Funds* Countryside IL 11/5/2010 1/1/2011 45,000 12/14/2010 2/16/2011
220 Midwest Operating Engineers Health and Welfare Fund Countryside IL 2/10/2011 1/1/2011 1,900 2/10/2011 2/16/2011
221 Teamsters Local 277 Welfare Fund Hempstead NY 1/19/2011 3/1/2011 791 2/14/2011 2/16/2011
222 Plumbers and Steamfitters Local Union 247 Health and Welfare Fund* Pineville LA 12/7/2010 1/1/2011 191 1/5/2011 2/17/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
223 South Central UFCW Unions and Employers Health and Welfare Trust Dallas TX 1/6/2011 3/1/2011 18,275 2/9/2011 2/17/2011
224 Storeworkers Security Plan New York NY 12/30/2010 2/1/2011 567 2/3/2011 2/17/2011 3/31/2011
225 Teamsters Local No. 20 Insurance Fund Toledo OH 12/6/2010 1/1/2011 19 2/3/2011 2/17/2011
226 Masters, Mates & Pilots Health & Benefit Plan
Linthicum Hts. MD 11/22/2010 1/1/2011 2,914 1/7/2011 2/18/2011
227
International Association of Bridge, Structural, Ornamental and Reinforcing Ironworkers Local Union No. 79 Health Fund Norfolk VA 2/4/2011 5/1/2011 500 2/16/2011 2/22/2011
228 International Association of Heat & Frost Insulators & Asbestos Workers Local 18 Indianapolis IN 1/28/2011 3/1/2011 674 2/16/2011 2/22/2011
229 North Central Illinois Laborers' Health and Welfare Fund Peoria IL 1/26/2011 7/1/2011 6,285 2/14/2011 2/22/2011
230 Teamsters Local 641 Welfare Fund Union NJ 1/25/2011 3/1/2011 1,974 2/15/2011 2/22/2011
231 Will County Local 174 Carpenters Welfare Fund Joliet IL 1/28/2011 3/1/2011 450 2/16/2011 2/22/2011
232
Amalgamated Meat Cutters & Retail Store Employees Union Local 342 Health Care Fund New York NY 12/1/2010 1/1/2011 3,020 2/16/2011 2/23/2011
233 Ironworkers Local Union No. 167 Welfare Fund Goodlettsville TN 1/7/2011 8/1/2011 625 2/15/2011 2/23/2011
234 Operating Engineers Local No. 474 Health & Welfare Fund Goodlettsville TN 1/7/2011 7/1/2011 440 2/14/2011 2/23/2011
235 Plumbers & Steamfitters Local No. 177 Health & Welfare Fund Goodlettsville TN 1/7/2011 8/1/2011 450 2/15/2011 2/23/2011
236 Plumbers and Fitters Local No. 110 Benefit Trust Fund Norfolk VA 1/7/2011 5/1/2011 875 2/14/2011 2/23/2011
237 Sheet Metal Workers Welfare Fund, Local No. 85 Atlanta GA 1/7/2011 7/1/2011 2,125 2/14/2011 2/23/2011
238 Tennessee Valley Painters Health Fund Goodlettsville TN 1/7/2011 5/1/2011 490 2/14/2011 2/23/2011
239 International Brotherhood of Electrical Workers Local 1501 Cockeysville MD 11/30/2010 1/1/2011 396 2/18/2011 2/24/2011
240 Ohio AFSCME Care Plan Cleveland OH 1/28/2011 3/1/2011 26,500 2/17/2011 2/24/2011
241 Roofer's Local No. 176 Health and Welfare Fund Goodlettsville TN 1/7/2011 5/1/2011 82 2/14/2011 2/24/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
242
Security, Police and Fire Professionals of America and Participating Employers' Health and Welfare Trust Fund Roseville MI 1/31/2011 4/1/2011 5,528 2/16/2011 2/24/2011
243 United Production Workers Union Local 17-18 Welfare Fund Brooklyn NY 2/11/2011 3/1/2011 2,049 2/17/2011 2/24/2011
244 HERE Local No. 274 Health Fund* Philadelphia PA 12/6/2010 1/1/2011 1,310 2/18/2011 2/25/2011
245
Sacramento Independent Hotel, Restaurant and Tavern Employees Welfare Trust Sacramento CA 1/31/2011 7/1/2011 194 2/21/2011 3/1/2011
246 Specialties & Paper Products Union No. 527 Health & Welfare Fund Mableton GA 12/10/2010 1/1/2011 1,725 2/24/2011 3/1/2011
247
United Food and Commercial Workers' Union Local 919 and Contributing Employers' Food Health and Welfare Fund Farmington CT 11/2/2010 8/1/2011 7,048 2/23/2011 3/1/2011
248
Bakery, Confectionery, Tobacco Workers & Grain Millers, Local 102 Welfare Fund Ozone Park NY 1/11/2011 1/1/2011 550 2/3/2011 3/2/2011
249 Pipefitters Local Union 195 Health & Welfare Fund Nederland TX 2/16/2011 4/1/2011 291 2/28/2011 3/2/2011
250 Teamsters Local 97 Benefits Fund Union NJ 2/8/2011 8/1/2011 708 2/23/2011 3/2/2011 251 West Virginia Laborers' Trust Fund Charleston WV 2/3/2011 4/1/2011 1,857 2/28/2011 3/2/2011 252 Allied Security Health and Welfare Fund Mineola NY 12/6/2010 1/1/2011 3,450 2/16/2011 3/3/2011 253 Iron Workers Local No. 16 Health Fund Baltimore MD 1/5/2011 1/1/2011 1,400 2/18/2011 3/3/2011
254 South Jersey Public Employees Health and Welfare Fund Williamstown NJ 12/21/2010 1/1/2011 600 2/24/2011 3/4/2011
255 Madelaine/Local 1222 Welfare Fund Long Beach NY 2/22/2011 4/1/2011 566 2/28/2011 3/7/2011 256 Teamsters Local 237 Welfare Fund New York NY 11/22/2010 1/1/2011 51,649 2/18/2011 3/8/2011
257 Minneapolis Retail Meat Cutters and Food Handlers Health & Welfare Fund Bloomington MN 1/27/2011 3/1/2011 10,720 3/7/2011 3/10/2011
258 Shreveport Electrical Health and Welfare Fund Shreveport LA 2/25/2011 4/1/2011 1,085 3/3/2011 3/10/2011
259 Southeastern Iron Workers Health Care Plan Pittsburgh PA 12/21/2010 2/1/2011 5,143 3/2/2011 3/10/2011
260
United Food and Commercial Workers Local #789 and St. Paul Food Employers Health Care Plan Bloomington MN 1/27/2011 3/1/2011 3,427 3/1/2011 3/10/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
261 Carpenters District Council of Kansas City Welfare Plan Kansas City MO 2/9/2011 4/1/2011 20,898 2/24/2011 3/11/2011
262 Chicago Plastering Institute Health & Welfare Fund Alsip IL 2/3/2011 4/1/2011 400 2/23/2011 3/11/2011
263 Fulton Fish Market Welfare Fund New York NY 12/6/2010 1/1/2011 1,211 3/7/2011 3/11/2011 264 Ironworkers Local No. 12 Health Fund Albany NY 1/31/2011 7/1/2011 605 2/25/2011 3/11/2011
265 Plumbers & Steamfitters Local 141 Health & Welfare Fund Shreveport LA 2/15/2011 5/1/2011 946 2/28/2011 3/11/2011
266 Asbestos Workers Local 42 Welfare Fund Columbia MD 1/4/2011 7/1/2011 179 3/14/2011 3/17/2011
267 Building Laborers Local 310 Health & Welfare Fund Cleveland OH 2/14/2011 5/1/2011 1,690 2/23/2011 3/17/2011
268 Cement Masons and Plasterers Local 518 Health Care Fund Kansas City MO 1/7/2011 8/1/2011 1,580 2/28/2011 3/17/2011
269 Local 306 Theatrical Employees Health Fund Lynbrook NY 2/25/2011 4/1/2011 878
3/1/2011 3/11/2011 3/17/2011
270 Midwestern Teamsters Health and Welfare Fund Itasca IL 1/24/2011 3/1/2011 392 2/23/2011 3/17/2011
271 Central Coast Trust Fund* Watsonville CA 2/14/2011 8/1/2011 791 3/1/2011 3/21/2011
272 District Council 1707 Health & Benefit Fund New York NY 1/24/2011 4/1/2011 1,137 3/8/2011 3/21/2011
273 Excavators Union Local No. 731 New York NY 11/22/2010 1/1/2011 1,510 3/8/2011 3/21/2011
274
Hotel Employees and Restaurant Employees International Union Welfare Fund
White Sulphur Springs WV 2/18/2011 4/1/2011 4,044 3/8/2011 3/21/2011
275 Jacksonville Plumbers and Pipefitters Health and Welfare Fund Jacksonville FL 2/10/2011 9/1/2011 1,075 3/7/2011 3/21/2011
276 Plasterers & Cabinet Makers Health Fund Minneapolis MN 2/14/2011 4/1/2011 1,033 3/3/2011 3/21/2011
277 Oklahoma/Arkansas Carpenters Health & Welfare Fund Dallas TX 2/1/2011 7/1/2011 1,649 3/10/2011 3/30/2011
278
United Food and Commercial WorkersLocal No.1529 and Employers Health and Welfare Trust Fund Memphis TN 3/1/2011 6/1/2011 10,459 3/1/2011 3/30/2011
279 Carpenters Local 127 Tucker GA 3/3/2011 6/1/2011 304 3/21/2011 3/31/2011
280 Plumbers and Pipefitters Local Union No. 803 Health and Welfare Fund Jacksonville FL 3/7/2011 8/1/2011 784 3/24/2011 3/31/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
281 Road Carriers Local 707 Welfare Fund - Plan H Hempstead NY 3/10/2011 9/1/2011 156 3/25/2011 3/31/2011
282 Southern California Local Union 831-Employer Health Fund El Monte CA 12/2/2010 1/1/2011 2,875 12/20/2010 3/31/2011
283 Stephenson County Board Freeport IL 12/7/2010 1/1/2011 348 2/23/2011 3/30/2011 3/31/2011
284 Iron Workers Local Union No. 28 Health and Welfare Fund Roanoke VA 12/22/2010 1/1/2011 570 3/10/2011 4/1/2011
285 Plumbers and Pipefitters Local No. 421 Health and Welfare Plan Macon GA 11/30/2010 1/1/2011 2,000 3/7/2011 4/1/2011
286 IUPAT District Council 78 South Florida FL 3/2/2011 1/1/2011 2,223 3/23/2011 4/4/2011 287 Journeymen & Apprentices Local 188 Tucker GA 3/2/2011 7/1/2011 1,070 3/24/2011 4/4/2011
288 Security Workers Health and Welfare Fund Baltimore MD 3/2/2011 4/1/2011 1,527
3/17/2011 5/12/2011
4/4/2011 7/7/2011
289 Southern Tier Building Trades Welfare Plan Jamestown NY 3/3/2011 5/1/2011 690 3/3/2011 4/4/2011
290 Teamsters Local 863 Welfare Fund Mountainside NJ 3/2/2011 4/1/2011 2,722 3/15/2011 4/4/2011
291 Washington Wholesalers Health and Welfare Fund Columbia MD 2/18/2011 4/1/2011 1,873 3/17/2011 4/4/2011
292 Carpenters Industrial Council Trust Fund Charleston WV 1/24/2011 2/1/2011 4,295 3/16/2011 4/6/2011
293 Plumbers and Steamfitters Local 60 Health and Welfare Fund New Orleans LA 3/16/2011 7/1/2011 2,234 3/29/2011 4/7/2011
294 Fleet Owners Insurance Fund Cleveland OH 2/4/2011 1/1/2011 350 3/28/2011 4/11/2011
295 IRC-CMMIC Local 721 City of Industry CA 3/8/2011
2/1/2011 7/1/2011 875 3/28/2011 4/11/2011
296 Local 734 Welfare Fund Chicago IL 3/17/2011 5/1/2011 514 4/7/2011 4/11/2011 297 New Jersey B.A.C. Health Fund Fairfield NJ 12/6/2010 1/1/2011 3,346 3/2/2011 4/11/2011
298
Southeastern Hotel Employees & Restaurant Employees Health & Welfare Fund Conyers GA 3/16/2011 7/1/2011 1,817 3/28/2011 4/11/2011
299 Teamsters Local 617 Welfare Fund* Ridgefield NJ 2/3/2011 3/1/2011 22 4/5/2011 4/13/2011
300 USW Local 1-0318 Health and Welfare Trust Fund* Flushing NY 3/3/2011 4/1/2011 2,039 4/12/2011 4/13/2011
301
United Association of Journeymen and Apprentices Local 198 AFL-CIO Health and Welfare Trust Baton Rouge LA 3/3/2011 9/1/2011 2,606 4/12/2011 4/13/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
302
Welfare Fund of the International Union of Operating Engineers Local 15, 15A, 15C, 15D AFL-CIO New York NY 11/19/2010
1/1/2011 1/2/2011 9,777 4/12/2011 4/13/2011
303 Local 475 IUE-CWA Pelham NY 12/6/2010 1/1/2011 489 3/29/2011 4/18/2011 304 MVM, Inc.* Ashburn VA 4/8/2011 12/1/2010 174 4/11/2011 4/19/2011
305 UFCW San Diego Employers Health & Welfare Trust* San Diego CA 3/7/2011 4/1/2011 54 4/18/2011 4/20/2011
306 SEIU Healthcare IL Home Care & Child Care Fund Chicago IL 3/29/2011 5/1/2011 5,897 3/29/2011 4/21/2011
307 Bakers Union and FELRA Health and Welfare Fund Sparks MD 12/2/2010 1/1/2011 213 4/12/2011 4/22/2011
308 CWA Local 1182 Security Benefits Fund New York NY 3/29/2011 7/1/2011 7,158 3/29/2011 4/25/2011
309 CWA Local 1183 Health and Welfare Fund New York NY 3/29/2011 9/1/2011 738 3/29/2011 4/25/2011
310 Detroit and Vicinity Trowel Trades Health and Welfare Fund Troy MI 3/31/2011 5/1/2011 2,573 4/19/2011 4/25/2011
311 Local 485 Health and Welfare Fund Columbia MD 4/1/2011 5/1/2011 660 4/20/2011 4/25/2011
312 Sheet Metal Workers Local 15 Medical Fund Goodlettsville TN 3/29/2011 8/1/2011 1,480 3/29/2011
4/27/2011 5/5/2011
313 Joint Benefit Trust Livermore CA 3/18/2011 5/1/2011 2,450 5/3/2011 5/4/2011
314 National Allied Workers Union Insurance Trust Fund Chicago IL 2/28/2011 4/1/2011 101 3/23/2011 5/4/2011
315 Plumbers Local Union No. 519 Health and Welfare Fund
Pembroke Pines FL 3/30/2011 5/1/2011 57 4/25/2011 5/5/2011
316 Rodman Local 201 Welfare Fund Towson MD 1/13/2011 7/1/2011 335 3/21/2011 5/5/2011 317 IATSE Atlanta Health & Welfare Fund Jonesboro GA 4/7/2011 7/1/2011 326 5/2/2011 5/11/2011 318 Carolina-Virginia UFCW and Employer Norfolk VA 4/15/2011 7/1/2011 2,990 5/10/2011 5/12/2011 319 Laborers Local 35 Health Fund Utica NY 2/28/2011 1/1/2011 407 5/2/2011 5/12/2011 320 Tennessee Valley Operating Engineers Goodlettsville TN 9/16/2010 11/1/2010 2,310 12/21/2010 5/12/2011
321
IBEW Local 508 and Eastern Division, Georgia Division NECA Health and Welfare Fund Tucker GA 4/1/2011 7/1/2011 1,029
4/1/2011 4/22/2011 5/16/2011
322 Milwaukee Carpenters District Council Health Fund Pewaukee WI 4/29/2011 6/1/2011 533 5/11/2011 5/19/2011
323 NECA-IBEW Local 176 Health and Welfare Fund Joliet IL 4/26/2011 6/1/2011 12 5/12/2011 5/19/2011
324 Teamsters Local 456 Health and Welfare Fund Elmsford NY 2/24/2011 1/1/2011 2,494 4/18/2011 5/19/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
325 Harris Farms, Inc. COALINGA CA 4/14/2011 9/1/2011 324 5/10/2011 5/20/2011 326 Health Fund 917 Floral Park NY 3/31/2011 5/1/2011 2,779 4/22/2011 5/20/2011
327 Local Union 854 IBT Health and Welfare Benefits Fund Garden City NY 3/24/2011 5/1/2011 1,885 4/25/2011 5/20/2011
328 Oregon Processors Employees Trust Portland OR 4/13/2011 6/1/2011 1,100 5/6/2011 5/20/2011
329 General Building Laborers Local 66 Welfare Fund Melville NY 4/12/2011 7/1/2011 2,104 5/5/2011 5/25/2011
330 Chicago Regional Council of Carpenters Welfare Fund Chicago IL 4/21/2011 7/1/2011 3,735 5/19/2011 5/26/2011
331 ILA 1478-2 Welfare Fund Newark NJ 3/23/2011 7/1/2011 1,120 5/11/2011 5/26/2011
332 New Mexico UFCW Union's & Employers' Health & Welfare Plan Albuquerque NM 4/21/2011 6/1/2011 996
5/18/2011 8/29/2011
5/26/2011 9/7/2011
333 Plumbers and Steamfitters Local Union No. 43 Health and Welfare Fund Goodlettsville TN 4/29/2011 7/1/2011 1,819 5/19/2011 6/1/2011
334 Day Care Council Local 205 DC 1707 Welfare Fund New York NY 4/15/2011 7/1/2011 10,822 5/6/2011 6/3/2011
335 Roofers' Local 195 Health and Accident Plan Cicero NY 4/28/2011 7/1/2011 250 4/28/2011 6/3/2011
336 Arkansas Pipe Trades Heath and Welfare Fund
Oklahoma City OK 5/9/2011 7/1/2011 754 5/24/2011 6/6/2011
337 Chicago Laborers' Welfare Fund Chicago IL 4/29/2011 6/1/2011 211 5/11/2011 6/6/2011
338 Insulators Local 112 Heath and Welfare Trust Fund Lake Charles LA 5/9/2011 7/1/2011 27 5/24/2011 6/6/2011
339 Southeastern SEIU Health and Welfare Fund Jonesboro GA 4/18/2011 7/1/2011 37 5/10/2011 6/7/2011
340 Western Teamsters Welfare Trust Seattle WA 5/13/2011 9/1/2011 353 6/3/2011 6/9/2011
341 Teamsters and Employers Welfare Trust of Illinois* Springfield IL 4/29/2011 5/1/2011 10 4/29/2011 6/13/2011
342 West Virginia Pipe Trades Health & Welfare Fund Wellsburg WV 4/30/2011 6/1/2011 2,579 4/30/2011 6/13/2011
343 International Brotherhood Electrical Workers Local 139 Welfare Fund* Elmira NY 5/16/2011 7/1/2011 6 6/7/2011 6/14/2011
344 Laborers Local 17 Health Benefit Fund Newburgh NY 11/8/2010 1/1/2011 1,700 6/15/2011 6/27/2011
345 Building Service 32BJ Health Fund* New York NY 5/3/2011 7/1/2011 35,888 5/3/2011 7/28/2011
6/29/2011 8/22/2011
Total Enrollment 1,051,624
Section B: Section B lists plans that did not apply for a one year waiver under the initial policy but did apply for, and received, a waiver good through 2013, under the June 17, 2011 policy. Plans must submit annual information about their plan and comply with requirements to ensure that their enrollees understand the limits of their coverage.
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
1 Employer-Teamsters Local Nos. 175 & 505 Health and Welfare Fund Charleston WV
11/24/2010 9/21/2011
1/1/2011 1/1/2012 2,857
12/28/2010 9/26/2011
12/30/2010 10/14/2011
2 United Benefit Fund Middle Village NY 11/24/2010 9/21/2011
1/1/2011 1/1/2012 5,355
12/17/2010 10/17/2011
1/12/2011 11/14/2011
3 Wine, Liquor & Distillery Workers Union Local 1-D Brooklyn NY
10/18/2010 12/1/2010 1/1/2011 739
1/11/2011 5/30/2011
1/18/2011 6/27/2011
4
Amalgamated Meat Cutters & Retail Food Store Employees Union Local 342 Health Care Fund New York NY
12/1/2010 9/22/2011 1/1/2011 5,151
1/18/2011 10/11/2011
1/31/2011 10/28/2011
5
District No. 9, International Association of Machinists and Aerospace Workers Welfare Plan St. Louis MO 4/28/2011 7/1/2011 7 5/17/2011 6/20/2011
6 Southern Illinois Laborers and Employers Health & Welfare Fund Cairo IL 4/14/2011 8/1/2011 550 5/11/2011 6/20/2011
7 Local 237 Teamsters Brentwood School District Welfare Trust Fund Islandia NY 5/26/2011 7/1/2011 388 5/26/2011 6/22/2011
8 Local 237 Teamsters North Babylon School District Health and Welfare Fund Islandia NY 5/26/2011 7/1/2011 295 5/26/2011 6/22/2011
9
Local 237 Teamsters Plainview-Old Bethpage School District Health and Welfare Fund Islandia NY 5/26/2011 7/1/2011 550 5/26/2011 6/22/2011
10 SEIU Local 4 Health & Welfare Fund Chicago IL 5/31/2011 7/1/2011 5,727 6/20/2011 6/27/2011
11 National Roofers Union and Employees Joint Health and Welfare Trust Fund Denver CO 6/1/2011 6/1/2011 38 6/7/2011 6/28/2011
12 IBEW Local 139 Welfare Fund Elmira NY 6/1/2011 7/1/2011 435 6/1/2011
6/29/2011 7/6/2011 7/11/2011
13 IBEW-NECA Southwestern Health and Benefit fund Dallas TX 4/6/2011 9/1/2011 525 4/6/2011 6/29/2011
14 Inter Lakes Health Ticondiroga NY 5/26/2011 11/1/2010 137 6/24/2011 6/29/2011
15 Plumbers and Steamfitters Local 100 of Dallas Health and Welfare Fund Plano TX 6/16/2011 7/1/2011 901 6/17/2011 6/29/2011
16 San Diego Teamsters Health & Welfare Trust Fund San Diego CA 5/31/2011 7/1/2011 58 5/31/2011 6/29/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
17 Texas Pipe Trades Health Benefit Fund Plano TX 4/22/2011 7/1/2011 4,103 6/1/2011 6/29/2011
18 Central New York Laborers' Health and Welfare Fund
East Syracuse NY 5/12/2011 7/1/2011 998 6/24/2011 7/1/2011
19 IUOE Local 14-14B Welfare Fund Flushing NY 6/1/2011 7/1/2011 3,714 6/1/2011 7/1/2011 7/6/2011
20 Plumbers and Steamfitters Local # 106 Health and Welfare Fund Lake Charles LA 6/8/2011 7/1/2011 713 6/28/2011 7/5/2011
21 CWA 1181 Security Fund Queens NY 6/1/2011 7/1/2011 1,260 6/29/2011 7/6/2011 22 Empire State Carpenters Welfare Fund Hauppauge NY 5/31/2011 7/1/2011 5,028 6/20/2011 7/6/2011 23 Laborers Local 190 Welfare Fund Glenmont NY 5/27/2011 8/1/2011 950 6/27/2011 7/6/2011
24 United Plant & Production Workers Local 175 Welfare Fund
Rosyln Heights NY 6/1/2011 7/1/2011 653 6/1/2011 7/6/2011
25 Pointers, Cleaners & Caulkers Welfare Fund New York NY 5/25/2011 7/1/2011 2,498 6/15/2011 7/7/2011
26 Washington Teamsters Welfare Trust Seattle WA 6/1/2011 7/1/2011 72 6/28/2011 7/11/2011
27 Aristacare Health Services South Plainfield NJ 6/20/2011 8/1/2011 287 7/6/2011 7/12/2011
28 National Asbestos Workers Medical Plan Columbia MD 6/17/2011 8/1/2011 48 7/7/2011 7/12/2011
29 Plasterers' Union Local 8 Health & Welfare Fund Philadelphia PA 4/12/2011 5/1/2011 349 6/21/2011 7/14/2011
30 Recycling and General Industrial Union Local 108 Welfare Fund New York NY
12/1/2010 9/22/2011
1/1/2011 1/1/2012 3,023
4/15/2011 9/22/2011
7/20/2011 12/13/2011
31 Local 522 Welfare Fund of New York & New Jersey Brooklyn NY 6/15/2011 8/1/2011 1,810 7/14/2011 7/21/2011
32 IPM Health & Welfare Trust of California Riverside CA 6/7/2011 9/1/2011 678 7/15/2011 7/25/2011
33 Road & Heavy Construction Laborers Local 1298 Nassau & Suffolk Counties Hempstead NY 6/8/2011 7/1/2011 2,095 7/15/2011 7/25/2011
34 City of Cohoes Cohoes NY 6/30/2011 7/1/2011 92 6/30/2011 7/26/2011
35 Construction Industry Laborers Welfare Fund
Overland Park KS 12/1/2010 1/1/2011 9,560 7/21/2011 7/29/2011
36 Union Roofers Health and Welfare Fund Downey CA 7/7/2011 9/1/2011 922 7/27/2011 7/29/2011
37 Minnesota Laborers Health and Welfare Fund
Mendota Heights MN 12/6/2010 1/1/2011 20,554 7/5/2011 8/8/2011
38 Local 298 Health Benefit Fund II Valley Stream NY 7/19/2011 8/1/2011 643 7/19/2011 8/9/2011 39 United Workers Health Fund 621A Island Park NY 7/27/2011 8/1/2011 201 7/27/2011 8/9/2011 40 Bonita Packing Co Santa Maria CA 6/16/2011 8/1/2011 31 8/2/2011 8/10/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
41 Western Labor Alliance Health and Welfare Trust Fund
Rancho Cucamonga CA 6/28/2011 8/1/2011 115 6/28/2011 8/10/2011
42 Electric Motor Shop, Inc. Fresno CA 7/29/2011 1/1/2012 60 7/29/2011 8/11/2011 43 IRON WORKERS WELFARE FUND Metairie LA 7/13/2011 8/1/2011 1,668 7/13/2011 8/12/2011
44
United Food & Commercial Workers Union Local 1546 Health & Welfare Fund Chicago IL 7/14/2011 9/1/2011 12,300 7/14/2011 8/12/2011
45 BAC Local Union 15 Welfare Fund Overland Park KS 3/1/2011 4/1/2011 1,070 8/8/2011 8/17/2011
46 CBT Transportation Group Employee Benefit Brooklyn NY 7/29/2011
9/1/2011 9/12/2011 708 8/11/2011 8/17/2011
47 Taylor Farms California, Inc. Salinas CA 8/4/2011 9/1/2011 3,321 8/4/2011 8/17/2011 48 Local 50 Benefit Services Trust St. Louis MO 5/9/2011 9/1/2011 78 7/29/2011 8/24/2011
49 Plumbers, Pipe Fitters and Apprentices Local No. 112 Health Fund Binghamton NY 7/27/2011 1/1/2011 1,650 7/27/2011 8/24/2011
50 Iron Workers Local 568 Cumberland MD 7/15/2011 9/1/2011 339 7/15/2011 8/25/2011 51 Local No. 1 Health Fund Chicago IL 5/31/2011 7/1/2011 3,511 7/28/2011 8/29/2011 52 Road Carriers Local 707 Welfare Fund Hempstead NY 7/11/2011 9/1/2011 3,137 7/27/2011 9/7/2011
53 United Health and Welfare Fund Englewood Cliffs NJ 7/19/2011 8/1/2011 65 8/8/2011 9/13/2011
54 Local 1205 Funds Farmingdale NY 6/2/2011 7/1/2011 1,994 8/17/2011 9/20/2011 55 Iron Workers Local No. 8 Welfare Fund Milwaukee WI 7/14/2011 6/1/2011 39 9/20/2011 9/23/2011 56 Brick Masons Health and Welfare Trust West Covina CA 4/4/2011 5/1/2011 180 9/21/2011 9/27/2011 57 I.B.E.W. Local 325 Joint Trust Fund Binghamton NY 9/12/2011 9/1/2011 258 9/12/2011 9/28/2011
58 Operating Engineers Health and Welfare Fund Local 12 Pasadena CA 5/25/2011 7/1/2011 22,840 9/22/2011 10/3/2011
59 Mid-South Iron Workers Welfare Plan Tulsa OK 9/21/2011 12/1/2011 975 9/21/2011 10/5/2011 60 Local 108 Health Expense Benefit Fund Irvington NJ 9/15/2011 8/1/2011 2,415 9/27/2011 10/11/2011
61 Operating Engineers Local 99 & 99A Health & Welfare Plan Baltimore MD 9/22/2011 1/1/2011 170 10/4/2011 10/14/2011
62
Board of Trustees of the Sheet Metal Workers Local 36 Arkansas Welfare Fund St. Louis MO 9/21/2011 1/1/2012 292 9/21/2011 10/17/2011
63 Carpenters and Joiners Welfare Fund Bloomington MN 9/21/2011 1/1/2012 21,364 10/11/2011 10/19/2011
64 Employers and Cement Masons Local 90 Health and Welfare Fund Troy IL 9/22/2011 8/1/2011 611 10/12/2011 10/19/2011
65 New Orleans Electrical Health Plan Goodlettsville TN 7/18/2011 1/1/2012 1,968 7/18/2011 10/26/2011
66 Local 303 I.A.T.S.E. Municipal Employees Health & Welfare Fund New York NY 5/3/2011 5/1/2011 570 10/25/2011 10/31/2011
Applicant City** State Application
Date
Plan Effective
Date
Number of
Enrollees Application Completed
Waiver Date
67 FELRA & UFCW Health and Welfare Fund Sparks MD 9/9/2011 1/1/2011 28,533 10/3/2011 11/14/2011
68 Upstate New York Engineers Health Fund Syracuse NY 9/9/2011 4/1/2012 5,698 9/27/2011 11/14/2011
69 Sheet Metal Workers Local #270 Welfare Fund
Oklahoma City OK 9/21/2011 2/1/2012 292 12/7/2011 12/12/2011
70 Carpenters Health & Security Plan of Western Washington Seattle WA 9/22/2011 1/1/2012 22,019 9/22/2011 12/13/2011
71 CWA 1181 Security Benefit Fund Queens NY 9/22/2011 7/1/2011 1,260 12/13/2011 12/14/2011
72 Pipe Trades Trust of the Northern Rocky Mountain Area 9/13/2011 9/1/2011 3,100 12/21/2011
Total Enrollment 226,595
*Waiver not extended; expires one year after plan effective date.
**Please note that the city and state correspond only to the address stated on the application and may not reflect the location of the applicant’s enrollees.