Wellness Exams

Effective July 1, 2019, the Health and Benefit Plan will no longer exclude out-of-network facilities and physician for the following well-ness exams:

Bone Density,
Cardiac Risk Assessments,
Cervical Exams,
Colorectal Cancer,
Diabetic Assessments,
Immunizations, Mammograms,
Pap Tests,
PSA (Prostate Cancer Tests)

As with all treatments performed in an out of network facility or performed by an out-of-network physician, payment for services received will be paid at the rate of 70% of 130% of the Medicare allowance.

Supplemental Unemployment Benefit Improvement (S.U.B. Fund)

Effective July 1, 2019, supplemental unemployment benefit fund balances of existing retirees or new retirees going forward will automatically be transferred into their HRA accounts.

Additionally, as some retirees could have a full HRA account, as well as a full SUB Fund account, the Trustees have voted to increase the HRA limit for retirees from $17,000.00 to $25,000.00.

For example, if a member had $8,000 in his or her S.U.B. Fund and had a full HRA account ($17,000.00) upon his or her retirement, the Plan would transfer over to this participants HRA account the $8,000.00. The new combined total of that retiree’s HRA account would then be $25,000.00.

Example #2: If upon retirement a member had $1,600.00 in his or her S.U.B. Fund account and $9,800.00 dollars in their HRA account, their S.U.B. Fund balance of $1,600.00 would be transferred to their HRA account which would subsequently total $11,400.00.

How does the transfer of the balance help a retiree?

Under the provisions of the S.U.B. Fund, retirees can only utilize S.U.B. Fund balances to offset self-payment premiums to the Health and Benefit Plan.

Smoking Cessation

You may or may not be aware that smoking is the leading cause of preventable death in the United States. Also, you may or may not be aware that the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan makes tobacco cessation services available to all participants enrolled in or provided through a physician-supervised smoking cessation program.

Plan P Improvements

Effective July 1, 2019, the following improvements will be made to the Plan:

All existing post 65 participants with Plan P credits less than or equal to $13.00 will be raised to the $14.00 going forward. And,
Participants retiring early (Pre-65) on or after July 1, 2019 that have 40 or more years of credit, will receive the full $58.00 Plan P rate.

Oral Contraceptives

Effective, July 1, 2019 the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan will cover oral contraceptives.

All current pharmaceutical co-pays and/or co-insurance provisions will apply to all oral contraceptive products prescribed by a treating physician.

Grand Rounds

Medicare data shows that just like there are “good” hospitals and “bad” hospitals, there also exist stark differences between “good” surgeons and “bad” surgeons. Every day, surgeons with the highest complication rates are performing operations in hospitals nationwide.

Diabetic Dietician & Nutritionist Benefit

The Board recognizes that anyone who has diabetes should be working with a registered dietitian or a registered nutritionist. After-all, managing blood glucose levels requires an understanding of how to balance food, exercise, and medication. As every diabetic is aware, unhealthy eating patterns contribute to the risk of complications such as cardiovascular disease and high blood pressure.

Heart Disease

As many of you know, February was American Heart Month. Heart disease is not just the leading cause of death in the United States, but also in the whole world. And it is just not one disease but rather encompasses a whole group of diseases which affect the circulatory system.