Benefits Connection

In This Issue...

Save Money with a Health Reimbursement Arrangement Program

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?

  • Pre-tax contributions are made on your behalf when you work under an applicable bargaining agreement. These contributions are collectively bargained on your behalf to help you and your family pay out-of-pocket eligible expenses. IRS regulations prohibit individuals from contributing to an HRA account.

What's the contribution amount?

  • The amount of the contribution is collectively bargained; the current hourly contribution is $0.25 per reported hour. Contributions aren't taken from your paycheck—they're additional contributions on top of the regular hourly contributions.

What are eligible expenses?

  • As an eligible participant, you can use the HRA to pay for expenses not covered by the Health Plan, such as medical bills you pay before you meet the Health Plan's annual deductible; doctor's office and pharmacy co-payments; over-the-counter medications prescribed by a physician; and much, much more.

How do I use my HRA account?

  • If you enroll, you receive an HRA debit card (two per family) once the first HRA contributions are made to your HRA account. Your card is accepted at most merchants where you may have eligible expenses (e.g. CVS, Rite Aid, Costco). You can pay for your eligible expenses with the card, but the card won't work for non-eligible expenses. You can also use the card to pay for medical bills that you receive from your doctor.

How do I keep track of my account?

  • The HRA Web Portal lets you access your account online. After logging in, you can see your account balance and past claims, upload receipts and submit claims for reimbursement, or pay eligible expenses (like a doctor's bill or a COBRA premium). To access the HRA Web Portal, visit Stay tuned for information about a mobile app for your HRA account!

The Importance of Staying In-Network

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:

  Network Non-Network
Provider rate $200 (network discounted rate) $400 (R&C)
Coinsurance amount 10% 20%
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.

Keep Your Southern California IBEW-NECA Information Up to Date!

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.

COBRA Self-Pay Rates for 2018

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:

  • Core option includes medical/behavioral health, prescription drug benefits and Member Assistance Program (MAP) only.
  • Core Plus option adds dental and vision to the benefits offered under the Core option.

Keep those check stubs!

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.

It's That Time Again: The Annual Pension Verification Process

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;

  • Your mailing address and other demographic information haven't changed; and
  • You're not working in any employment prohibited by Plan rules. The Administrative Office recently sent reminders to everyone who still needs to complete and mail in their forms.

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.

Important Contact Information

Southern California IBEW/NECA
Health, Pension, and Defined Contribution plans
(IBEW Local 11/LA NECA)

Phone: 323-221-5861

IBEW Local 441 Health
NECA/IBEW Family Medical Care
Plans 14, 15, & 17
5837 Highway 41 North
Ringgold, GA 30736
Phone: 877-937-9602
Fax: 706-937-9601

Orange County IBEW/NECA
Electrical Workers Defined Contribution Pension Plan
(IBEW Local 441)
United Administrative Services

Phone: 800-743-5274

IBEW Local 440 Health
NECA/IBEW Family Medical Care
Plans 14 &16

5837 Highway 41 North
Ringgold, GA 30736
Phone: 877-937-9602
Fax: 706-937-9601

Local 477 Health Trust
Delta Fund Administrators, LLC

1234 W. Oak
Stockton, CA 95203
Phone: 209-474-5671
Fax: 209-474-5771

Inland Empire IBEW-NECA
Pension Plan

c/o The Gem Group
401 Liberty Avenue, Suite 1200
Pittsburgh, PA 15222-1024
Phone: 844-731-7311 (toll free)

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