I.B.E.W. Local No. 25

To All Participants:

The benefits described in the following pages have been made available to You through the joint action of the Employer and the Union Trustees.

The Trustees will continue to make every effort to maintain benefits within the limits of Fund income and assets for the greatest possible advantage of each Participant and Dependent.

On the following pages You will find a description of the principal provisions of the Plan Benefits. You should read this material carefully and become familiar with the terms of the Plan and Your
rights under it.

The Trustees are responsible for the administration of the Plan. We will be happy to assist You in every way possible to make certain that You promptly receive the benefits to which You are
entitled. If at any time You need information or assistance, write or call the Fund Office.

Sincerely,
The Board of Trustees

MANAGEMENT TRUSTEES
Steven Cadieux
Paul Dunn
Clifford Seaman
Pat Santoro

LABOR TRUSTEES
Kevin M. Harvey
James P. Malley
Sean Meehan
Sean Plant

FUND MANAGER
John W. Gilday

NOTICE OF GRANDFATHERED STATUS

The Trustees of the I.B.E.W. Local 25 Health & Benefit Fund believe this Plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your Plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

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 at (631) 434-3344. You may also contact the Employee Benefits Security Administration, 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.