Paraprofessional Health & Welfare Fund


Look How Far We’ve Come! It’s true — we’ve come a long way. Over the years we’ve made many improvements to your Health and Welfare Fund benefits, and your package of benefits just keeps getting better. As a member of the Boston Teachers Union Paraprofessional Health and Welfare Fund, you have access to high-quality dental care, vision care and prepaid legal services, plus other services highlighted in the brochure. Your health and well-being are important to us, and that’s why we designed the Boston Teachers Union Paraprofessional Health and Welfare Fund benefits to supplement your City of Boston medical plan benefits.

To learn more, click on one of the tabs below:

Paraprofessional Dental Benefit

The Fund offers covered Paraprofessionals Delta Dental PPO Plus Premier.

The plan will provide coverage for:

  • Periodic exams and cleanings
  • X-Rays as required
  • Dental services (other than orthodontia), up to a maximum of $1,310 per year
  • Orthodontia - for adults and children, up to a lifetime maximum benefit of $2,000

The Delta Dental Premier Option

The Delta Dental PPO Plus Premier Option is administered by Delta Dental of Massachusetts. The one plan provides coverage under two national networks: Delta Dental PPO and Delta Dental Premier. There is a $1,310 annual maximum (excluding orthodontia) under this plan. There is also a separate annual maximum of $1,000 per person for covered implant procedures only. To your benefit, implant-related procedures (abutments and crowns) will be applied toward the overall annual maximum amount

The Schedule of Covered Dental Procedures under this plan provides dental coverage for eligible individuals to go to any licensed dentist.

To see if your dentist is part of either of the national networks: Delta Dental PPO or Delta Dental Premier you can go to the Delta Dental web site at www.deltadentalma.com or contact the customer service department at 800-872-0500.

Eye Care Benefits

The eye care benefits provided by your Health and Welfare Fund are available exclusively at our own, private Eye Care Center. The Eye Care Center is located within the Boston Teachers Union Building, off of Day Boulevard in Dorchester. We are located a short walk from the MBTA Red-Line JFK / UMASS station, and we have ample free parking at the BTU building.

For information about your eye care benefits please click on one of the following:

  • examExamination
  • wearEyewear
  • addlAdditional Benefits / Contact Lenses
  • memberMember Only Benefits
  • schedScheduling

Your eye care benefit includes a comprehensive eye examination and one pair of prescription eyeglasses every year. When appropriate, additional non- emergency ophthalmologic medical / surgical evaluations can be scheduled at the Eye Care Center. This benefit is provided by your Health & Welfare Fund at no cost to yourself. Your spouse and dependant children are eligible to receive this benefit as well, at no cost.

The eye examination is a comprehensive examination covering all aspects of the visual system and the health of the eyes. The examination will include checks for cataracts, glaucoma, macula degeneration, retinal problems, external eye diseases, injuries and infections as well as tests of color vision, depth perception and peripheral vision. This testing protocol averages 30 minutes per patient, so you should arrive on time for your appointment and allot enough time at the Eye Care Center for your examination and subsequent selection of eyeglasses, should they be necessary. We are unable to provide any ‘baby-sitting’ services at the Eye Care Center, so you should make your own arrangements for the care of your children, at home, for the time you are at the Eye Care Center.

Should you require further evaluation of a specific problem or a surgical consultation with our ophthalmologist, a return visit for that purpose can be scheduled for you at the Eye Care Center.


Should you require prescription eyeglasses, one pair of prescription eyeglasses per year will be provided to you at the Eye Care Center at no charge. Additional lens enhancements that are currently, and may become available in the future with the advances in technology of lens manufacturing, can be purchased before your eyeglasses are ordered. Currently these items include Transitions photochromatic lenses, Crizal anti-reflection coating, polarized sun lenses and high index, polycarbonate and aspheric extra-thin lenses.

All eyeglasses are warranted for damage or breakage by the Eye Care Center and will either be repaired or replaced, at the discretion of the Eye Care Center staff. This repair/replace warranty will apply, repeatedly if needed, until the patient is eligible for new eyeglasses again.

Lost or stolen eyeglasses and non-prescription sunglasses are not covered by this warranty and cannot be replaced under this benefit. However replacement eyeglasses may be purchased at the Eye Care Center. Currently there is no limit to the number of additional pairs of eyeglasses, spares or replacements, a member or eligible dependant may purchase at the Eye Care Center.


Your eyecare benefit includes a comprehensive eye examination and one pair of prescription eyeglasses every year. Additional office visits, for emergency care and follow-up visits may also be scheduled at the discretion of the Eye Care Center staff in consultation with one of the Eye Care Center doctors.

Your eye care benefit also includes partial coverage for the fitting and provision of medically necessary contact lenses at a doctor of your choosing, outside of the Eye Care Center. Medically necessary contact lenses are used to compensate for defects or deformities of the eyes that prevent the correction of the vision by eyeglasses. This does not include situations where contact lenses are for cosmetic or occupation needs that can be taken care of by eyeglasses. This medical need has to be certified by one of the doctors at the Eye Care Center during the patient’s examination. Once the medical necessity has been certified, this benefit allows for the reimbursement to the patient of up to $100.00 toward their cost for the fitting and supply of contact lenses by the vendor of the patient’s choice. This benefit is renewable on the same cycle as the rest of the eye care benefit.

Contact lenses for non-medical vision correction use are not available through the benefit or for purchase at the Eye Care Center. However, all of the professional services from initial contact lens fitting, to lens handling and care instructions, all follow-up evaluations and the provision of a written prescription for the purchase of contact lenses, can be provided in conjunction with the eye examination benefit. At this time, this benefit is available for members and partners / spouses only, and is not transferable to another family member.


All of the above benefits are available to all members and their covered dependents. There are also, a number of benefits, described below, that at the present time are available only to the members.

Non-prescription sunglasses selected by the Eye Care Center staff may be provided to members in lieu of prescription eyeglasses for those members who do not need or want prescription eyeglasses. Non-prescription sunglasses are NOT covered under the warranty as are prescription eyeglasses. This one pair of non-prescription sunglasses will be the entire eyeglass benefit for a full 12 month cycle.

A one-time-only-benefit exists for the provision of a single pair of replacement eyeglasses for replacement of the most recent set of eyeglasses provided by the Eye Care Center, that have been lost or stolen at school or during a school authorized activity or function. In order to apply for this benefit, a member will need to provide written documentation, on official school letterhead, signed by the Headmaster or immediate supervisor, stating the circumstances and situation in which the eyewear disappeared.


Due to the large number of patients for whom we provided services, 7000 covered members plus their families, who are all eligible for services at the Eye Care Center, we are unable to see patients for services without appointments. This applies for all eyeglass services as well as examination services. Individuals who come to the Eye Care Center for services without appointments may have to be turned away and scheduled an appointment to return for services.

During the periods when school is in session, the Eye Care Center is open sixty (60) hours a week, including evenings and Saturdays. During school vacations, the schedule is modified to a day-time, work-week schedule to accommodate the members’ changed availability.

To schedule an appointment or to seek any further information, please call;

Boston Teachers Union Health and Welfare Fund
Eye Care Center
180 Mount Vernon Street
Boston ( Dorchester), MA 02125

(617) 288-5540

Hospitalization Income Supplement Benefit

(For Covered Paraprofessionals Only)

Important

If you’re hospitalized for more than a week, the Plan will pay you a benefit of $150 per week for up to 51 consecutive weeks of hospitalization. The amount of the income supplement is shown in the chart below:

Consecutive Days
in Hospital
Benefit
0-6 None
7-13 $150
14-20 $300
21-27, etc. $450, etc.

Instructions

Please complete the Claim Form in its entirety but only complete the block at the top of the Hospital Verification Form.

Return both forms to us. We’ll take care of contacting the hospital involved in each case and we also verify your “Covered Paraprofessional” status.

Obviously, the sooner you mail us back the forms, the sooner we can proceed with our part. Please do not divert from this procedure as it can only delay your benefit.

Also, the Internal Revenue Service has determined that this type of benefit represents taxable income. You should then, report the income on your income tax form for the year in which the benefit is received.

View the Paraprofessional Hospitalization Income Supplement Benefit Form


Paraprofessional Hearing Aid Benefit

Instructions

IMPORTANT: Read and follow the instructions on this form.

If a Covered Paraprofessional or eligible dependent requires a hearing aid, the charge for the hearing aid, up to a maximum of $5,000 ($2,500 per ear) will be paid by the Fund directly to the supplier, provided the following requirements are met:

  1. The eligible person has undergone an Audiology Test which has been authorized by a licensed physician and conducted at an approved hospital facility; and
  2. AND
  3. The prescription issued for the hearing aid by the Audiology Department of an approved hospital facility is taken to a supplier recommended by the Hospital’s Audiology Department.

A HEARING AID BENEFIT WILL NOT BE PAID FOR HEARING AIDS PURCHASED THROUGH A SUPPLIER WHO IS NOT RECOMMENDED BY AN APPROVED HOSPITAL FACILITY, NOR FOR A HEARING AID OF THE SAME PRESCRIPTION AS ONE PREVIOUSLY PAID FOR BY THE FUND FOR THE SAME PATIENT AND THE SAME EAR.

Definition of Approved Hospital Facility
For the purpose of this benefit, an approved hospital facility is:

  1. A hospital recommended by the Harvard Pilgrim Health Care, Blue Cross/Blue Shield — sponsored Health Maintenance Organization (HMO), or other HMO, for those eligible persons covered by such a plan;
  2. OR
  3. Beth Israel Deaconess Medical Center, 110 Francis Street, Boston, Massachusetts 02215 for all other eligible persons. (Call the hospital's Division of Audiology directly at (617- 632 -7300 for an appointment.)
  4. OR
  5. Other such facility as approved by the Board of Trustees

Note: This benefit does not include payment for any portion of the charge made by the hospital for the Audiology Test.

THE FUND MAKES PAYMENT DIRECTLY TO THE SUPPLIER

This benefit does not pay for repairs nor does it pay for replacement of a lost or damaged hearing aid, so recipients may want to insure their hearing aid against loss or damage.


Click to view and print the Hearing Aid Benefit Claim Form


Paraprofessional Funeral Expense Benefit


Instructions

If you have paid the funeral expenses of a Covered Paraprofessional who has recently passed away, you may be eligible to make application for the benefit.

In the event that funeral expenses are incurred as a result of the death of a person who is a Covered Paraprofessional at the time of his/her death, the Fund will pay a funeral expense benefit equal to the amount of such expense, but not exceeding one-thousand dollars ($1,000.00).

The Fund will make payment of this funeral expense benefit to the estate of the Covered Paraprofessional or to a person equitably entitled thereto, in the opinion of the Trustees, upon satisfactory proof of payment of such expense.

If you wish to apply for the benefit, please complete the application and return it with a copy of the death certificate and receipt of bills. Please feel free to call if you have any questions.


Click View & Print the Application for Funeral Expense Benefit.


Paraprofessional MedicAlert Benefit

The Plan will pay for one MedicAlert ID if you or a family member has a medical condition that needs to be identified in an emergency situation.

Instructions

Please review the attached forms, complete the appropriate form carefully and clearly and return it to:

B.T.U. Paraprofessional Health and Welfare Fund
180 Mount Vernon Street
Boston, MA 02125-3198

Do not send the form to MedicAlert.

However, before you complete and return your form to us for processing, you should be aware that although the Boston Teachers Union Paraprofessional Health and Welfare Fund will pay to the MedicAlert Foundation International, their charge for your MedicAlert membership, and will forward your MedicAlert Enrollment Form, or otherwise, to the MedicAlert Foundation, your compliance with the conditions and instructions on the MedicAlert Enrollment Form and the service provided by the Foundation are not responsibilities of the Fund.

Please review your completed form for accuracy before sending it to us.

Your benefit includes the basic MedicAlert ID. If you select a product other than the basic stainless steel type, you must enclose a check payable to the B.T.U. Paraprofessional Health and Welfare Fund for the difference in cost.

Please sign and date the displayed letter and return it with your completed form.

View and Print the MedicAlert Application

View and Print the Kid Smart MedicAlert Application

Paraprofessional Prepaid Legal Services Benefit

The Board of Trustees of the Prepaid Legal Services Fund has selected a panel of attorneys so that you and your eligible dependents may receive legal help with a variety of services such as buying or selling your principal residence or preparing a will. Also, participating mediators can assist you in separation and divorce disputes.

Attorneys and mediators who participate in the Prepaid Legal Services Plan (participating providers) can help you with a variety of legal services, such as:

Boston Teachers Union Paraprofessional Prepaid Legal Services Plan Providers

To take advantage of the Prepaid Legal Services that the Plan offers, contact the Fund Office. The Fund Office will explain what you need to do to receive quality legal services.

Click to view the Paraprofessional Prepaid Legal Services Authorization Form.


Paraprofessional Sources of Possible Benefits to Deceased BTU Members/City Employees

  1. The Retirement Board
    City Hall
    Telephone #: (617) 635-4311
  2. The “Small Retirement Fund”, c/o Jim Kennan
    P.O. Box 33
    Dorchester, MA 02122
    Telephone #: (617) 624-6748
  3. With his/her Group Health Insurance
    City Hall, Boston
    Telephone #: (617) 635-4570
  4. To research whether they had annuity or other savings deductions made, contact the Payroll Department of the Treasurer’s Office
    City Hall
    Telephone #: (617) 635-4151
  5. You have probably already approached the BTU Paraprofessional Health & Welfare Office
    Telephone #: (617) 288-5883, relative to funeral expense benefits
  6. Also check with the Tremont Credit Union to see if person had any accounts with them
    Telephone #: (781) 843-5626
  7. Check with the Boston School Department, Office of Human Resources to see if there was any time left in sick-bank
    Telephone #: (617) 635-9600

This web site is maintained by Innovative Software Solutions, Inc.