- Active Health
- Retiree Health
- DB Pension
- DC Pension
- SUB Plan
Issue 13, Fall 2017
In This Issue...
As health care costs keep rising, every dollar counts. That's why, through collective bargaining, the Southern California IBEW-NECA Health Trust Fund recently introduced a Health Reimbursement Arrangement (HRA) for participants under Inside Wireman, Intelligent Transportation Systems, and Railroad CBAs.
Think of the HRA as an extra checking account, but one you only use for health care. Through the HRA, the Fund creates an account for each eligible participant. Contributions go into the account to help you pay for your eligible health care expenses, giving you more money in your pocket.
How is my HRA account funded?
What's the contribution amount?
What are eligible expenses?
How do I use my HRA account?
How do I keep track of my account?
If you are covered under the Southern California IBEW-NECA Health Trust Fund's Medical and/or Dental PPO options, you have a choice between network and non-network providers. Choosing a provider in the Health Plan's network will help you save money.
The most obvious way you save money by visiting a network provider is the coinsurance amount. Typically, the coinsurance amount for a network provider is 90% versus 80% for non-network providers. But are you paying a percentage of the same charge? Not exactly.
Usually, health care providers set their price by looking at the going rate of a service within their particular area. This price is called the "reasonable and customary" (R&C) amount.
Providers who are part of the Plan's network agree to charge discounted rates for their services. Non-network providers, on the other hand, generally charge the full R&C amount. So, when you receive care from a nonnetwork provider, the coinsurance you pay is applied to a higher non-discounted rate, which likely means higher out-of-pocket costs for you.
If you visit a non-network provider, you're not just paying the R&C charge. If the R&C amount is more than the in-network discounted rate, you must pay the difference between the two—on top of the higher (20%) coinsurance you already pay for an out-of-network service.
Below is an example of what you might pay (after meeting your deductible) depending on if you visit a network or non-network provider:
|Provider rate||$200 (network discounted rate)||$400 (R&C)|
|What you pay in coinsurance||$20||$80|
|Difference between network rate and R&C amount||N/A||$200|
|Total you pay||$20||$280|
|Amount you save||$260||N/A|
You may already visit a network provider, such as your primary care physician (PCP), but you may be referred to a non-network provider. Before you visit any health care provider, always check whether or not the provider is in the network. To find providers in the PPO network visit Anthem Blue Cross Prudent Buyer PPO.
Your PCP and other doctors aren't the only types of providers who can be network or non-network providers. Labs, anesthesiologists and even entire hospitals may be outside of the Plan's network. For example, when you get your annual physical from your PCP and he or she sends out a blood sample for tests, the lab your PCP's office uses may not be a network provider. If you're not sure if a certain provider is in your network, it never hurts to ask.
When it comes to your benefits, your personal information is the key to making sure you receive them. At least once a year, review your Beneficiary Designations, address, birthdates, SSNs, and other relevant information. This helps ensure the Administrative Office has an accurate file on you and your family.
Even if you update your personal information with your union, you must still notify the Funds' Administrative Office of any changes. The Administrative Office is separate from your union, so changes reported to the union Local aren't necessarily sent to the Administrative Office.
Incorrect personal information may delay benefits to you or your beneficiaries in the event of your death. It doesn't hurt to double-check who you have listed as your beneficiary. For example, if you're divorced but you haven't updated your beneficiary information, your ex-spouse may still be listed as your beneficiary.
It's also critical that family members notify the Administrative Office as soon as possible when you or an eligible spouse pass away. The change may have an immediate impact on pension benefits, depending upon the option selected. It may also affect the monthly deduction for your Southern California IBEW-NECA Retiree Health Plan participation.
Effective January 1, 2018, the rates for COBRA continuation coverage in the Southern California IBEW-NECA Health Trust Fund Active Health Plan will change. If you're currently on COBRA continuation coverage, you'll receive a letter from the Administrative Office that includes these rates and your options going forward.
COBRA continuation coverage lets you maintain your Fund health coverage at the full contribution rate, which you pay out-of-pocket, in addition to a 2% administrative fee. You can apply for COBRA continuation coverage when you no longer meet the eligibility requirements for your current coverage (for example, if you don't have enough hours).
A subsidized COBRA program is available to participants who qualify. This program lets you pay a reduced rate for the first three consecutive months after enrolling. If you don't qualify for the Fund's Subsidized COBRA program, you can still pay non-subsidized COBRA rates for the entire COBRA coverage period.
The Health Fund offers two benefit options under COBRA continuation coverage:
It's important to hang onto your check stubs and match them with quarterly statements from the Funds' Administrative Office. If there are any discrepancies, contact the Administrative Office at 323-221-5861 or toll free at 800-824-6935.
Your health benefits may not be reinstated retroactively, so it's important that you notify the Administrative Office as soon as possible after you notice a potential discrepancy. The benefit providers for the Southern California IBEW-NECA Health Trust Fund will generally not accept retroactive premiums or provide retroactive benefits beyond a typical 60- or 90-day time frame.
If you notify us as soon as possible, it will help ensure that you receive the benefits to which you're entitled.
In July 2017, participants that are receiving a pension benefit from the Southern California IBEW-NECA Pension Plan (the Plan) received an Annual Pension Verification (APV) packet from the Administrative Office that included forms you need to complete and send back as soon as possible.
The Administrative Office sends this packet every year to verify that: • You received all your pension checks from the prior year;
If you don't complete and return the forms from your APV packet by December 15 of this year, your pension check will be withheld and your participation in the Southern California IBEW-NECA Retiree Health Plan will be cancelled beginning January 1, 2018.
The responsibility is yours; don't allow your Plan benefits to lapse or your participation in the Retiree Health Plan to cease.
For more information on the process, view the video.
Southern California IBEW/NECA
Health, Pension, and Defined Contribution plans
(IBEW Local 11/LA NECA)
IBEW Local 441 Health
NECA/IBEW Family Medical Care
Plans 14, 15, & 17
5837 Highway 41 North
Ringgold, GA 30736
Orange County IBEW/NECA
Electrical Workers Defined Contribution Pension Plan
(IBEW Local 441)
United Administrative Services
IBEW Local 440 Health
NECA/IBEW Family Medical Care
Plans 14 &16
5837 Highway 41 North
Ringgold, GA 30736
Local 477 Health Trust
Delta Fund Administrators, LLC
1234 W. Oak
Stockton, CA 95203
Inland Empire IBEW-NECA
c/o The Gem Group
401 Liberty Avenue, Suite 1200
Pittsburgh, PA 15222-1024
Phone: 844-731-7311 (toll free)