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What You Must Do Now 1. Consider your benefits needs and those of your family so you can choose the medical plan and Choice Benefits that are right for your personal situation. 2. If you are satisfied with your current elections, do nothing. Your 2003 medical plan and Choice Benefits will continue in year 2004. 3. Review your current elections. If you are currently participating in the Personal Choice medical plan, consider switching to the Keystone Point of Service or Dual Income option. That way you will have additional benefit credits to buy other benefits. 4. If you want to switch medical plans, or change how you use your benefit credits, complete the enrollment form. 5. If you are electing Keystone Point of Service for the first time, select a Primary Care Physician (PCP) for yourself and each eligible family member. Enter the name and number of the PCP on your election form. Physician directories are available from the Fund Office or on the Internet at www.ibx.com. Once you enter the Independence Blue Cross Web Site, go to the "Members" section and click on "Providers." 6. If you are choosing the Dual Income option for the first time, complete and sign the Proof of Other Coverage form. 7. If you choose to deposit benefit credits in the Retirement 401(k) plan, and you are not currently participating in the plan, complete and sign the Choice Plan Credit Allocation and Beneficiary Form. 8. Return all the appropriate forms to the Fund Office. All new benefit elections will be effective January 1, 2004. |
Earning Benefit Credits
 Remember, if you choose a lower cost medical plan, you receive benefit credits. The Dual Income option will free up the most dollars, and therefore give you the most benefit credits. |
| Medical Plan Options | Annual Benefit Credit |
| Personal Choice | None |
| Keystone Point of Service | $240 |
| Dual Income Option | $1,200 |
| You earn your benefit credits on a monthly basis. If you become ineligible to participate in the Health & Welfare Fund benefit program at any time during the year, you will stop earning benefit credits. You will be entitled to any benefit credits you earn up to the date you become ineligible. |
If You Do Not Return An Enrollment Form If you do not return a Choice Plan Enrollment Form: 
You will remain in your current medical plan and other plans in accordance
with your collective bargaining
agreement.
Your Choice Benefit options will remain the same
(if you are currently enrolled in the Keystone Point of Service or Dual Income option.)
For other than the Retirement 401(k) plan, you will not have another
opportunity to change your options until January 2005 (unless you have a qualified Life Event).
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