Home Health & Welfare
NOTICE-HEALTH INSURANCE MARKETPLACE AND YOUR HEALTH COVERAG

LOCAL 52

HEALTH AND WELFARE FUND

 

NOTICE ABOUT HEALTH INSURANCE MARKETPLACE AND

YOUR HEALTH COVERAGE

 

            The Trustees of the Plumbers & Steamfitters Local 52 Health and Welfare Plan ("Fund") are providing you this notice to help clear up any questions you may have about how the Health Insurance Marketplace ("Marketplace") affects your health coverage under the Fund.  On October 1, 2013, open enrollment will begin for the Marketplace (formerly referred to as the “Exchange”), which is one of the central aspects of the Health Care Reform law known as the Affordable Care Act ("ACA").  Each state will have a Marketplace offering Qualified Health Plans ("QHPs") that may be purchased by individuals and small businesses.  Coverage under QHPs purchased in the Marketplace becomes effective January 1, 2014.

             ACA requires your employer to provide you with a notice about the Marketplace and your ability to purchase health coverage through the Marketplace before open enrollment begins.  However, the required model notice is not specifically tailored to a multiemployer plan arrangement. As a result, you may find the Notice confusing.

The Marketplace will have no effect on your coverage under the Fund.  You will continue to be a Participant of the Fund as long as you meet the eligibility requirements stated in the Summary Plan Description.  Your employer will continue making contributions to the Fund on your behalf as long as you are working under a collective bargaining agreement requiring such contributions.

 If you lose eligibility for coverage under the Fund due to a reduction in hours or termination of employment after January 1, 2014, the Marketplace may offer an attractive alternative for health coverage for you or you may choose to purchase continuation coverage offered by the Fund pursuant to the Consolidated Omnibus Reconciliation Act of 1985 ("COBRA").  (Although permitted self-payments for those of you who are short the requisite hours in a given quarter may be a cheaper alternative to purchasing insurance through the Marketplace). The premiums to purchase a QHP in the Marketplace may be less expensive than the cost of COBRA coverage and you may qualify for a new kind of tax credit that lowers your monthly premiums in the Marketplace.  You can see what your premium, deductibles, and out-of-pocket costs will be in the Marketplace before you make a decision between paying for COBRA coverage, making self-payments (if applicable), or purchasing coverage through the Marketplace.

 For more information about the Marketplace, you can refer to www.healthcare.gov or call 1-800-318-2596, which is the federal government's hotline for questions about the Marketplace.

 Please feel free to contact the Fund Office at 334-272-0240 X5 if you have any further questions.

 
Health Insurance

Health, Dental and Vision premiums for 2017.

Health insurance - $988.00

Dental and Vision coverage is now included with health coverage as an added benefit of the plan.

Health Coverage is through Blue Cross Blue Shield of Alabama. 1-800-292-8868

Dental Coverage is through Guardian. 1-800-541-7846

Vision Coverage is through VSP.  1-800-877-7195

 

 

 

 
Health & Welfare

If you need additional information, contact Kay Pinckard at 334-272-0240 ext. 4.

Health Insurance Information

The current health insurance provider is Blue cross Blue Shield of Alabama. You may contact BCBS at 1-800-292-8868 with any coverage or claim questions. You may also find participating providers and print claim forms at www.bcbsal.com.

The health insurance premium effective 01/01/17 is $988.00 per month.

If you are traveling or live out-of-state, please contact BCBS at 1-800-810-2583 to find a participating provider in your area.

Dental is now a benefit of the health & welfare plan when you are covered.  Dental coverage is provided by Guardian.  You may them  at 800.541-7846 with any coverage or claims questions. www.guardiananytime.com
Vision is now a benefit of the health & welfare plan when you are covered.   Vision coverage is provided by VSP.  VSP does not issue id cards. A participating provider can verify your coverage via your social security number.  You may contact VSP at 800.877.7195.with any coverage or claims questions.  www.vsp.com


Effective January 1, 2017, the contribution rate is $6.29 per hour.

For additional information, please click on the SPD document listed at the right.

How Can You Help Control Health Insurance Costs

Health care costs continue to rise. As you know, our health insurance premiums are directly influenced by our claims. Therefore, leading to higher insurance premiums. The following tips will help you manage your health care, and the costs that go with it, more effectively.

~~ Ask your doctor and pharmacist if generic drugs can be substituted for specific drugs prescribed. Generics are made available after the brand name patent has expired. They are equally effective and safe and contain the same basic active ingredients as brand name drugs. Generic drugs are reimbursed at 100% with no deductible, compared to the Brand name that is reimbured at 80% after a $500 deductible. If there is no generic available, ask your doctor for samples.

~~ Make sure you understand how any test, x-ray or procedure relates to the diagnosis and treatment of your illness. Don't be afraid to ask your doctor questions. It keeps you informed about your health and may keep your costs down.

~~ If you are planning a hospital stay, ask your doctor if routine tests can be performed before you are admitted to the hospital.

~~ Use the Emergency room for Emergencies ONLY. Emergency room visit costs are almost double that of a visit to your regular doctor. Please visit your regular doctor for everyday illnesses.

~~ Review bills from doctors and hosptials. Ask the hospital for an itemized statement. Bills could contain mistakes. If you find an error, please contact the provider immediately.

~~ Have outpatient surgery when the procedure can be safely and effectively performed as part of your treatment. Outpatient surgery can spare you a hospital stay, letting you recover in your own home.

~~ Sign up for InfoSolutions, Blue Cross' medical information network. Information such as chronic illnesses, test results, procedures, filled prescriptions, immunizations and allergies are stored securely so that authorized doctors can access it for use during your treatment and care. This may lead to faster diagnosis and treatment for you.

~~ If you have a chronic disease such as diabetes, asthma, coronary artery disease or congestive heart failure, consider participating in Blue Cross' Care Management program. This program focuses on managing these conditions to improve your health and wellness.

~~ Routine medical procedures are performed during the week in most hospitals. Going into the hospital on the weekend to wait for a Monday procedure can be costly. Make sure any weekend stay is medically necessary.

~~ Follow a healthy lifestyle. More information about healthy living can be found at www.bcbsal.com by selecting the "For Your Health" link.

Source: Blue Cross Blue Shield of Alabama flyer fyh124. "Blue Cross Blue Shield of Alabama and the Local 52 Health & Welfare Plan care about your health and wellness. "For your Health" is an informational series designed to provide you with specific ideas for ensuring you and your family enjoy a healthy and safe lifestyle. Sources are available upon request."

24-Hour Toll-Free Nurse Hotline

Did you know that Blue Cross Blue Shield of Alabama offers a 24-hour toll free Nurse Hotline? With Blue Cross' Care Management hotline, an experienced nurse is a phone call away to help you with answers to your health care questions. With the hotline, you have immediate access to a registered nurse 24 hours a day, 7 days a week, 365 days a year. This valuable service is free by calling:
1-800-896-2724

When you call the Care Management hotline, nurses provide information on:
* Effective home treatment and prevention
* When to call your physician
* Communicating effectively with your doctor
* Preparing for doctor visits
* Making wise decisions about tests, medications and surgeries
* Understanding prescription medications and how to make them work well for you
* Lifestyle choices to improve your health

The information you discuss with Care Management nurses may be printed and mailed to you if you prefer.

Health care information is also available on the website. For online access to a health library containing the most comprehensive health information available, visit www.bcbsal.com and select "For Your Health Wellness Tools for You."

There is no cost to you for calling the Care Management 24 hour hotline.

Source: Blue Cross Blue Shield of Alabama flyer fyh205.

BCBS Online Services

Blue Cross Blue Shield of Alabama's website now has many online services.

How to get Started.....
1. Go to www.bcbsal.com.
2. Sign in to CustomerAccess (register for this free service if you have not already done so).
3. Select the services offered:
* File your prescription drug claims
* Order replacement id cards
* Find a participating provider
* Download claim forms
* Verify full-time student status
* ...and much more

Available 24 hours, 7 days a week.
Get Started Today!!

 


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