Messages from the Fund Manager
It's hard to believe that 2016 is coming to a close. The years seem to be flying by quickly. As most of you probably already know, there have been some changes to your health insurance coverage. Effective January 1, 2017, Excellus Blue Cross Blue Shield will be administering your medical and hospital benefits. Claims incurred on or after January 1, 2017 must be submitted directly to Excellus. Please be sure to use your new Member ID card for any health care services received on or after January 1, 2017. Medical & Hospital Claims incurred prior to January 1, will be handled by the Fund Office. Also, please note that the Fund Office will continue to administer your Dental, Orthodontia, Vision, Supplemental Disability, Supplemental Fund and WRA Benefits. New Vision & Dental ID cards will be sent to you in early January. Your Prescription Benefits will continue to be administered by Express Scripts. A mailing (Summary of Material Modification—SMM) was sent to all participants in early October which outlined all the changes made to your health insurance coverage. Listed below are some of the changes:
|Deductible Per Individual
|Deductible Per Family
|Hospital Admission||$100 Copay||$200 Copay, 30% Coinsurance|
|Diagnostic Tests & Imaging||20% Coinsurance||40% Coinsurance|
|Inpatient Health Care Practitioner Visits & Surgeon's Fees||20% Coinsurance|| 40% Coinsurance|
Note: Many of the providers that participants currently use already participate in the Excellus or Blue Card PPO Networks, meaning that for most, there is no reason to change your doctor or hospital that you currently use. However, we highly recommend that you contact your medical providers to ensure that they participate in the Excellus PPO or Blue Card PPO Network before visiting them in 2017.
You can also find out if your doctor is in network by visiting ExcellusBCBS.com. To find a participating doctor or hospital, click on "Find your Doctor or Hospital" along the top of the page. Then select "Nationwide Blue Card Provider Network." Choose "Blue Card PPO/EPO" to verify the provider participates. An external link to Excellus' site is provided on our home page. You may also call Excellus at (800) 499-1275 to obtain in-network information.
Below are some of the changes made to your prescription benefits. Please see the Welfare Fund SMM at the bottom of this page for a complete listing of the benefit changes.
Non-Specialty Prescription Drugs (Retail—Greater of a 30-day supply or 100 units)
|Brand Preferred||20% Coinsurance ($20 Min/$40 Max)|
|Brand Non-Preferred||20% Coinsurance ($40 Min/$80 Max)|
If you have any questions regarding the benefit changes, do not hesitate to contact our office at (585) 424-3510 or (800) 288-0782. An additional mailing outlining the benefit changes in more detail will be sent to all participants in early January.
The Fund Office Staff wishes all of you a Merry Christmas & Happy New Year. Happy Holidays!
Welfare Fund SMM