HOW DOES THE HEALTH & WELFARE HOUR BANK SYSTEM WORK? AND HOW ARE HOURS REPORTED TO THE HEALTH & WELFARE PLAN?
The Plumbers & Steamfitters Local Union 52 Health & Welfare Plan was created to provide health coverage to Eligible Employees. While the Plan provides an Hour Bank to be used by Qualified Participants and Eligible Employees during times when work is slow or not available, the Hour Bank is not a vested benefit and use of it is limited to Eligible Employees as provided in the Plan’s governing documents. Under the terms of the Plan, an Eligible Employee is an individual who is employed by or seeking employment with an Employer to render services which under the terms of a collective bargaining agreement or other agreement require the Employer to make contributions to this Plan. You currently meet these guidelines and are eligible for coverage.
However, should it be determined, that you are no longer employed or seeking employment with an Employer who contributes to the Plan. Consequently, you are not an Eligible Employee or Qualified Participant. As such, you would no longer have access to an Hour Bank to continue coverage under the Plan. Without the Hour Bank, you would not have sufficient hours for participation in the Plan. At that time, your coverage under the Plan would terminate and you would receive Notice of Continuation Coverage under COBRA. Any remaining Hour Bank balance will be forfeited to the Plan.
Hour Bank and Health Premiums effective January 1, 2024 - The health & welfare benefit rate isf $7.96 per hour. Bbased on working 162 hours each month to cover the health premium of $1287.00. Premiums are deducted from your hour bank on the 1st of each month for the following month (ex: on 01/01/20, premium for 02/01/20 is deducted. Local Contractors are required to remit hours to the Plan by the 15th of the month following the work month (ex: January work hours will be received in February). Premium notices are mailed around the 15th of each month if your hour bank is depleted. If you receive a premium notice, please do not disregard it…you are receiving the notice because 1) you have been out of work and your hour bank is depleted or 2) you are working out of town and your hours have not been received. Please call the Benefit Office immediately so we can contact the Contractor or Local to locate your hours. Please note that your health & welfare hour bank insurance coverage is based on hours received…not hours worked. Therefore, if you are working out of another Local, have not worked enough hours or hours have not been received by the plan… and you receive a premium notice, you must pay the premium for your health insurance coverage to continue.
When working through another Local, it normally takes 2-3 months, sometimes longer, for the Plan to begin receiving hours worked. The health & welfare rate per hour is different for each Local. Therefore, based on that rate you may need to work more/less hours to cover the premium each month. If the rate for that Local is less, then you would need to work more hours to cover the monthly premium. This lower rate could cause a reduction in your hour bank balance and over time may cause you to owe premium out of your pocket. If the rate for the Local is more, then you would need less hours to cover the monthly premium and this should help increase your hour bank balance.
This Plan is legally required to inform you that although Local 52 expects coverage provided by the Health & Welfare Plan to continue in its present form for an undeterminable period, it is subject to modification or termination at any time.
For additional information, please read the Benefit Booklets and Summary of Benefits located under the Document/Health & Welfare section.
2020 VSP Vision benefit summary
How Can You Help Control Health Insurance Costs
Health care costs continue to rise. As you know, our health insurance premiums are directly influenced by our claims. Therefore, leading to higher insurance premiums. The following tips will help you manage your health care, and the costs that go with it, more effectively.
~~ Ask your doctor and pharmacist if generic drugs can be substituted for specific drugs prescribed. Generics are made available after the brand name patent has expired. They are equally effective and safe and contain the same basic active ingredients as brand name drugs. Generic drugs are reimbursed at 100% with no deductible, compared to the Brand name that is reimbured at 80% after a $500 deductible. If there is no generic available, ask your doctor for samples.
~~ Make sure you understand how any test, x-ray or procedure relates to the diagnosis and treatment of your illness. Don't be afraid to ask your doctor questions. It keeps you informed about your health and may keep your costs down.
~~ If you are planning a hospital stay, ask your doctor if routine tests can be performed before you are admitted to the hospital.
~~ Use the Emergency room for Emergencies ONLY. Emergency room visit costs are almost double that of a visit to your regular doctor. Please visit your regular doctor for everyday illnesses.
~~ Review bills from doctors and hosptials. Ask the hospital for an itemized statement. Bills could contain mistakes. If you find an error, please contact the provider immediately.
~~ Have outpatient surgery when the procedure can be safely and effectively performed as part of your treatment. Outpatient surgery can spare you a hospital stay, letting you recover in your own home.
~~ Sign up for InfoSolutions, Blue Cross' medical information network. Information such as chronic illnesses, test results, procedures, filled prescriptions, immunizations and allergies are stored securely so that authorized doctors can access it for use during your treatment and care. This may lead to faster diagnosis and treatment for you.
~~ If you have a chronic disease such as diabetes, asthma, coronary artery disease or congestive heart failure, consider participating in Blue Cross' Care Management program. This program focuses on managing these conditions to improve your health and wellness.
~~ Routine medical procedures are performed during the week in most hospitals. Going into the hospital on the weekend to wait for a Monday procedure can be costly. Make sure any weekend stay is medically necessary.
~~ Follow a healthy lifestyle. More information about healthy living can be found at www.bcbsal.com by selecting the "For Your Health" link.
Source: Blue Cross Blue Shield of Alabama flyer fyh124. "Blue Cross Blue Shield of Alabama and the Local 52 Health & Welfare Plan care about your health and wellness. "For your Health" is an informational series designed to provide you with specific ideas for ensuring you and your family enjoy a healthy and safe lifestyle. Sources are available upon request."
24-Hour Toll-Free Nurse Hotline
Did you know that Blue Cross Blue Shield of Alabama offers a 24-hour toll free Nurse Hotline? With Blue Cross' Care Management hotline, an experienced nurse is a phone call away to help you with answers to your health care questions. With the hotline, you have immediate access to a registered nurse 24 hours a day, 7 days a week, 365 days a year. This valuable service is free by calling:
1-800-896-2724
When you call the Care Management hotline, nurses provide information on:
* Effective home treatment and prevention
* When to call your physician
* Communicating effectively with your doctor
* Preparing for doctor visits
* Making wise decisions about tests, medications and surgeries
* Understanding prescription medications and how to make them work well for you
* Lifestyle choices to improve your health
The information you discuss with Care Management nurses may be printed and mailed to you if you prefer.
Health care information is also available on the website. For online access to a health library containing the most comprehensive health information available, visit www.bcbsal.com and select "For Your Health Wellness Tools for You."
There is no cost to you for calling the Care Management 24 hour hotline.
Tel-A-Doc
IMAGINE waking up with flu symptoms, but you can’t get in to see your Primary Physician. What should you do? No worries… With Teladoc, connecting with a doctor is
EASY. See the link below for more information.
