Overview
The BOLR Part-Time and Weekend Worker Plan offers you and your eligible dependents dental and vision benefits. You also have access to Life and Accidental Death and Dismemberment (AD&D) insurance, in addition to disability income protection.
Vision Care Program
The BOLR Part-Time and Weekend Worker Plan offers complete vision care for routine eye exams, glasses, or contact lenses through the National Vision Administrator (NVA) participating provider network of ophthalmologists, optometrists, and opticians. If you don’t use participating NVA providers, you’ll be reimbursed for a portion of the cost of eye exams, glasses, or contact lenses.
| Vision Benefit Summary | ||
| Service | NVA Provider | Non-NVA Provider |
| Eye exam | 1 free exam every 24 months (12 months for children under age 19) | $30 allowance for one exam every 24 months (12 months for children under age 19) |
| Lenses and frames | $120 allowance every 24 months (12 months for children under age 19) | $60 allowance for lenses and $60 allowance for frames every 24 months (12 months for children under age 19) |
| Contact lenses | $120 allowance every 24 months (12 months for children under age 19) | $60 allowance every 24 months (12 months for children under age 19) |
Dental Benefits
Our dental plan, provided through Delta Dental, covers a wide range of dental services, including diagnostic and preventive care. This chart gives you a quick look at the Dental Benefits. Please refer to your Summary Plan Description for complete information about the benefits.
| Dental Benefit Summary | |
| Service | Coverage (in-network) |
| Deductible | None |
| Annual Maximum Benefit | $2,000 per person, per year |
| Preventive and Diagnostic Care | 100% |
| Basic Restorative Care | 100% |
| Major Restorative Care | 100% |
| Orthodontia | 50% ($4,500 lifetime maximum; for children only, except for medically necessary adult treatment) |
Life Insurance and Accidental Death & Dismemberment Insurance (Death Benefit—Participant Only)
Life insurance is designed to protect your family, or anyone who relies upon your income, in the event of your death. Accidental Death and Dismemberment (AD&D) insurance pays a benefit to you if you suffer an accidental loss of a limb or your eyesight, and pays a benefit to your beneficiaries if you die as a result of a covered accident. The Fund pays for $25,000 of life and AD&D coverage for you. The specific amount of dismemberment coverage is determined by your loss.
Dependents are not eligible for life or AD&D coverage, but you may designate one or more dependents as your beneficiary. Contact the Fund Office if you need to update your Beneficiary Information Form.
Short-Term Disability Benefits
If you’re a part-time employee, you’re eligible for disability benefits in the event that you’re disabled and unable to work. A legally qualified physician or MHC mental health/substance abuse provider must certify your disability.
You’ll receive a disability benefit of for up to 26 weeks due to illness or an accident. There’s a waiting period of seven working days after you visit your doctor to certify your disability. Part-time and weekend employees receive a weekly (or weekend) benefit of $30. To submit a disability claim, contact the Fund Office.
