Important Plan Changes Effective January 1, 2009


MEDICAL:

Well-Child Care

The well-child benefit will be increased from $350 to $500 per calendar year for well-child visits and immunizations provided in the BCBS PPO network.  This benefit is available to your children through the age of 18.

Maximize your Benefit!  The CVS Minute Clinics are in the BCBS PPO network and can provide school and sports physicals and most of the required immunizations at a reasonable overall cost.

PRESCRIPTION DRUGS:

The calendar year limit per individual for prescription drugs will be increased from $10,000 to $15,000.  

Maximize your Benefit!  Use the Caremark mail order service to fill medications you will be taking for a longer period of time.  Have your physician prescribe generic or allow generic substitution whenever possible.  

DENTAL:

The calendar year limit for dental services has been increased from $1,500 per family to $1,500 per participant.    (Orthodontia continues to be a separate $1,000 lifetime maximum benefit for the children.)

There will be a $50 calendar year deductible per participant for dental services.  This deductible is waived for orthodontia and preventive dental care, such as your cleanings and preventive exams and diagnostic dental xrays associated with your check-ups.  

Maximize your Benefit!  Use a Delta Dental PPO Dentist and your preventive care will be covered at 100% and your out-of-pocket expenses will likely be lowered for all other services due to favorable contractual pricing. 

VISION:

We are pleased to introduce VSP (Vision Service Plan) as a new partner of Local 399’s Health and Welfare Plan.  VSP has an extensive network of vision providers throughout the United States and the Chicagoland area.  The Plan will provide more services for your vision benefit when you use a VSP provider.  For example, your eye exam will be covered after a $10 copay; frames and lenses will be covered after a $20 copay.  Additional vision related services will be available at a discounted amount when you use a VSP provider.

 
Annual Benefit Compliance Notice


In compliance with the provisions of the:

   •  Health Insurance Portability and Accountability Act of 1996 (HIPAA), Local 399’s Health and Welfare Fund staff and business partners will protect the confidentiality of your Protected Health Information (PHI)  that relates to your past, present or future health treatment.

   •  Women’s Health and Cancer Rights Act of 1998, your H&W Plan provides benefits for mastectomy related services and complications resulting from a mastectomy (including lymphedema).  These benefits include reconstruction and surgery to achieve breast symmetry and prostheses.  All plan provisions, such as deductible and co-insurance apply. 

   •  Newborns and Mothers’ Health Protection Act, the H&W Plan will not restrict benefits for any hospital stay in connection with childbirth to less than 48 hours following a normal vaginal delivery or 96 hours following a cesarean section.

 

 
WebMD Internet Tool Available to Local 399 Members

IUOE is offering access to a new WebMD based Health Manager website to IUOE Local 399 members across the country.  Members of the union will have access to this specialized suite of WebMD tools such as a personalized Health Quotient/Questionnaire, a Condition Center that addresses specific medical issues, and a Health Tracker that includes a means to record your personal health record.  Please take advantage of this opportunity by logging on to www.iuoe.org and clicking on the WebMD icon on the International’s home page.  You will be asked for your union registration and initiation date.
 
Condell Hospital Returns to BCBS PPO Network


Condell Medical Center has been purchased by Advocate Health Care and will return to the BlueCross BlueShield PPO Network effective as of December 1, 2008.  The new name of the hospital will be Advocate Condell Medical Center.

 

 

 
Do You Have a Full-Time College Student Covered by the Plan?
Eligible dependent children on Local 399’s H&W Plan who are between the ages of 19 and 23 and are enrolled in a Spring 2007 semester at college may be able to carry their coverage through the summer.  If your child will be returning to school in the Fall 2007 semester, you can extend their coverage through August if you complete and sign a document advising the Fund of this intention.  Please call the Fund Office for further information. 
Health and Welfare Tip

Effective January 1, 2007, coverage always ends on the last day of the month in which:

  • you terminate or are terminated from your employer
  • you retire
  • your dependent child turns age 19 or;
  • your dependent child turns age 23  (if a full-time student)
  • you divorce (for your spouse)

COBRA continuation coverage is available for 18 or 36 months after coverage ends, depending on the reason coverage is terminating.  If you or a member of your family is losing health and welfare coverage, call H&W within 60 days of losing coverage to be sure your COBRA continuation coverage information is sent to you for consideration.

 
Emergency Room Bound?
Knowing when and when not to go to the emergency room can save a life – or can delay care for others with true emergencies and contribute to the high cost of health care. Over a million Americans used emergency room services last year and an estimated one in five visits was for a non-urgent condition. read more ...