Expiration of the COVID-19 Public Health and National Emergency Requirements

The Health Plan rules for coverage of COVID-19 testing, vaccines and antiviral treatment are described as follows:

• • COVID-19 Testing Changes for the Cigna Medical and Optum RX Plans: No More Coverage of Over-the-Counter (OTC) Tests as of May 12, 2023

Under the PHE, laboratory-based polymerase chain reaction (PCR) and over the counter (OTC) antigen tests were required to be covered without cost-sharing. The Health Plan was also required to cover 8 free OTC tests per month, with a $12 limit per test. As of May 12, the Health Plan will only cover COVID-19 tests in accordance with both Cigna’s and Optum RX’s standard policies:

• • • Cigna Medical Plan – OTC test kits will no longer be covered under the Cigna medical plan. PCR tests will continue to be covered under the medical benefit for all 3 Tiers based on the standard lab benefit provisions
      for that Tier (which may be different for in and out-of-network coverage).
    • Optum RX Plan – OTC test kits will no longer be covered under the Optum RX plan.

• • COVID-19 Vaccine Coverage Changes: Only Vaccines Obtained through the Cigna Medical Plan Will
    Be Covered as of May 12, 2023:

During the PHE, the Fund covered COVID-19 vaccines at no cost to the participant, through both the Cigna
medical plan and the Optum prescription drug plan, for all 3 Tiers.

As of May 12, 2023, the Fund’s 3 Tiers will all continue to cover COVID-19 vaccines at no cost, but only when obtained from an in-network provider through the CIGNA medical plan –which would also include retail pharmacies that are in-network with Cigna. Coverage for vaccines obtained from an out-of-network medical provider will be based on the rules for your Tier of coverage. The Fund will no longer cover vaccines obtained at a pharmacy with Optum RX. For a complete list of in-network providers, including locating retail pharmacies, please visit www.mycigna.com.

• • COVID-19 Antiviral Medication Treatment Changes for the Optum RX Plan: 

Since 2022, the Federal Government has provided COVID-19 antiviral prescription drugs at no cost; this
supply is expected to run out some time in 2023. This medication is currently only being administered under the Optum RX benefit and is not available under the Cigna medical plan. Optum RX will continue covering this medication at 100% (meaning no cost to you) as long as supplies from the Federal Government last. After that supply of drugs from the Federal Government has been exhausted, the Health Plan will charge a co-payment of 30% of the cost of the medication under all 3 Tiers. This medication will fall into Optum RX’s expected Non-Preferred/Non-Formulary drug class category, with a quantity limit of 1 treatment course per fill and up to 2 courses permitted per year. There is a possibility that Optum RX could place this drug class in a different category in the near future in which the out-of-pocket copayment cost would eventually become cheaper.

Here are 2 charts that summarizes how each of the benefit items will be covered under either the Cigna
Medical/Optum RX Plans beginning May 12, 2023:

Cigna Medical Plan:

Benefit	Tier 1 – In Network	Tier 1 Out-of-network*	Tier 2 In-Network	Tier 2 Out-of-Network**	Tier 3 – In-Network Only***
Lab Tests (PCR)	Plan pays 100%	Plan pays 70% of reasonable and Customary charges after deductible has been satisfied	Plan pays 100%	Plan pays 70% of reasonable and Customary charges after deductible has been satisfied	Plan pays 75%
OTC Test Kits	Not covered	Not covered	Not covered	Not covered	Not Covered
COVID-19 Vaccine	Plan pays 100%	Plan pays 70% of reasonable and Customary charges after deductible has been satisfied	Plan pays 100%	Plan pays 70% of reasonable and Customary charges after deductible has been satisfied	Plan pays 100%
COVID-19 Antiviral Medication	Not covered – covered under the Optum RX plan. See chart below	Not covered – covered under the Optum RX plan. See chart below	Not covered – covered under the Optum RX plan. See chart below	Not covered – covered under the Optum RX plan. See chart below	Not covered – covered under the Optum RX plan. See chart below

*Tier 1 calendar year (January 1-December 31) deductible is $500 for an individual and $1,000 for a family. Once an out-of-pocket maximum limit of $7,000 for an individual, and $14,000 for family coverage, has been met, the Plan will pay 100% of Reasonable and Customary charges.

**Tier 2 calendar year (January1-December 31) deductible is $4,000 for an individual and $8,000 for a
family. Once an out-of-pocket maximum limit of $8,000 for an individual, and $16,000 for family coverage, has been met, the Plan will pay 100% of Reasonable and Customary charges.

***Tier 3 Once an out-of-pocket maximum limit of $4,550 for an individual, and $9,100 for family
coverage has been met, the Plan will pay 100% of Reasonable and Customary charges. For the covered benefits listed in the chart above, a calendar year deductible does not apply.

Optum RX Plan

Benefit	Tier 1 – In Network at a Retail Pharmacy****	Tier 1 Out-of-Network at a Retail Pharmacy****	Tiers 2 and 3 In-Network Only at a Retain Pharmacy*****
Lab Tests (PCR)	Not covered	Not covered	Not covered
OTC Test Kits	Not covered	Not covered	Not covered
COVID-19 Vaccine	Not covered	Not covered	Not covered
COVID-19 Antiviral Medication	Plan pays 100% while the government supply is available. Once the supply ends, 30% coinsurance of the cost of the drug with a minimum copay requirement of $25 will be required.	Plan pays 100% while the government supply is available. Once the supply ends, 30% coinsurance of the cost of the drug will apply.	Plan pays 100% while the government supply is available. Once the supply ends, 30% coinsurance of the cost of the drug with a minimum copay requirement of $60 will be required.

****Tier 1 calendar year (January 1-December 31) deductible is $100 for an individual and $200 for a family.

*****Tiers 2 and 3 calendar year (January 1-December 31) deductible is $100 for an individual and $200 for a family. Also, you must use an in-network pharmacy for Tiers 2 and 3. There is no out-of-network drug coverage.

The annual out-of-pocket maximum limits for covered prescription drugs for all 3 Tiers combined is $4,000 per individual, $8,000 per family each calendar year (January1-December 31). Once these limits have been met, the Plan will pay 100% of the cost of the medication.

The end of the extension of certain deadlines under the Health, Pension and 401(k) Plan after July 10, 2023 is also described below:

If you have medical coverage through an HMO Plan, please check with your HMO provider as to how they will be covering these specific benefit items beginning May 12, 2023. Details can also be located on line with your applicable HMO provider. For Emblem Health – HIP NY, visit, www.emblemhealth.com. For any of the Kaiser HMO plans, please visit www. www.kaiserpermanente.org.

• COBRA (Election and Payment), Special Enrollment, and Claims and Appeals Deadlines Changes:

As previously announced, certain deadlines were extended (up to one year) during the COVID-19 pandemic.  Specifically, the deadlines to elect and pay for COBRA, request special enrollment, and submit a claim or appeal were extended during the “Outbreak Period,” which is ending July 10, 2023.

Since the Outbreak Period is ending on July 10, 2023, all days after that will count toward any applicable deadline.  For example, for someone enrolled in COBRA, payment is normally due on the first day of the month, with a 30-day grace period.  Therefore, the COBRA payment for June 2023 would normally be due June 1, with a grace period until July 1.  However, because the days during the Outbreak Period do not count toward the deadline to pay for COBRA, the 30-day grace period will start to run on July 11 (i.e., until August 9).  However, the payment for August 2023 will be subject to the regular deadlines (described in the Summary Plan Description), since that falls after the end of the Outbreak Period.

The end of the Outbreak Period on July 10, 2023 means that those first offered COBRA before July 10, 2023 will have 60 days after July 10, 2023 (or until September 8) to elect COBRA (except that your deadline will not be extended for more than one year).  Please note that the extended deadlines do not affect your responsibility to make full payment of COBRA premiums retroactive to the first day for which you are eligible for COBRA coverage, in the event that you timely elect such coverage.  In addition, since claims incurred in any month you are eligible for COBRA will not be paid until you timely elect and pay for COBRA coverage for that month, you may need to re-file claims submitted before you elect and pay for COBRA for that month.

Please review and if you have any questions, please contact the Benefit Services Department and a representative will assist you during the hours of 9:30 AM to 5:30 PM EST.