SUMMARY OF MATERIAL MODIFICATIONS FOR MEDICARE ELIGIBLE RETIREES AND MEDICARE ELIGIBLE DEPENDENTS
Wednesday, November 26, 2025
SUMMARY OF MATERIAL MODIFICATIONS
FOR MEDICARE ELIGIBLE RETIREES AND MEDICARE ELIGIBLE DEPENDENTS
November 2025
Dear Medicare Eligible Participant:
This notice, referred to as a Summary of Material Modifications (SMM), describes important changes to the benefits offered by the National Automatic Sprinkler (NAS) Metal Trades Welfare Fund (Fund) effective January 1, 2026. We encourage you to read this notice carefully and to keep it with your Summary Plan Description and Plan Document (Plan). If you have any questions, please contact the Fund Office.
Important Benefit Changes Effective January 1, 2026
In recent years, healthcare and prescription drug costs have surged. In addition, the Plan has seen increased enrollment and an increased number of high-cost claimants. Consequently, the amount of money the Fund pays in benefits has increased significantly. Accordingly, in an effort to lessen the impact of these issues on the Fund’s financial resources, the following changes to the Plan’s Schedules of Benefits (Plan A, Plan B, and Plan C) will take effect on January 1, 2026:
- Increased Deductibles for Dental Benefits. Effective January 1, 2026, your deductibles for dental benefits will increase to $150/individual and $450/family. Currently, your deductibles are $75/individual and $225/family. A deductible is the dollar amount you must pay out-of-pocket for dental expenses before the Fund begins paying for such expenses.
- Lower Annual Maximum for Dental Benefits. Effective January 1, 2026, the Fund will pay up to $2,000 in covered dental benefits per person per calendar year. Currently, the annual maximum is $3,000. This means the Fund will pay for its portion of your dental benefits (after you reach your deductible) based on the Plan’s coinsurance rules until the Fund has paid a total of $2,000. Upon reaching the $2,000 annual maximum, you will be responsible for additional costs until the following year.
- Elimination of Vision Benefits from Vision Service Plan; No Change to Free Annual Eye Exam Offered by Aetna®. Effective January 1, 2026, the Plan will no longer offer vision benefits through Vision Service Plan (VSP). Currently, after you pay a $10 deductible, annual examinations and covered materials are paid in full if you use a VSP provider; there is no VSP coverage for vision related expenses incurred out of the VSP network. For clarity, Aetna® will continue to cover one routine vision exam every twelve months at no charge.
Conclusion
The Trustees are sympathetic to the impact of these Plan changes. They sought to make meaningful adjustments that would yield cost-savings for the Fund while balancing the financial burden Participants and their families would shoulder. If you have any questions about this correspondence, or the Fund in general, please feel free to contact the Fund Office.
This summary of material modifications is intended as a non-technical summary of certain changes to the rules of the NAS Metal Trades Welfare Fund, so it does not contain all the details. It modifies the information set forth in the Fund’s Summary Plan Description and Plan Document that was previously provided to you. In the event of a discrepancy between this summary of material modifications and the official Plan document, the official Plan document, as interpreted and applied solely by the Trustees pursuant to their exclusive discretionary authority, will prevail. The Trustees reserve the right to modify the official Plan document and the benefits offered by the NAS Metal Trades Welfare Fund at any time. Benefits offered by Aetna® are available only to Medicare-eligible individuals enrolled in the Aetna® Medicare Advantage and Prescription Drug Program offered by the NAS Metal Trades Welfare Fund. In the event of a discrepancy between this notice and the official plan documents for the Aetna® Medicare Advantage and Prescription Drug Program offered by the NAS Metal Trades Welfare Fund, those official plan documents, as interpreted and applied solely by Aetna®, will prevail.