The No Surprises Act:

The No Surprises Act provides greater transparency in healthcare billing. When you get emergency care at an in-network hospital or get treated by an out-of-network provider at an in-network hospital or in-network outpatient surgical center, you are protected from surprise billing or balance billing. Click on the link below from Anthem for more information.

https://www.anthem.com/blog/health-insurance-basics/understanding-cost-transparency/

EFFECTIVE JANUARY 1, 2022
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

Effective January 1, 2022, the prescription drug reimbursement by the Plan will increase from 70% to 80% of cost using the Caremark/CVS discount card. The Participant pay will be reduced from 30% to 20%. See link below to the Summary of Material Modifications.  You can now enroll online on this website, as well as update your address and beneficiary.  See link below to Online Enrollment.

• SUMMARY OF MATERIAL MODIFICATIONS
• ITPEU Online Enrollment

Effective January 1, 2020, all Participants with a contribution rate of $4.40 and above will have vision benefits for dependents restored and dental deductibles reduced.  See link below to the Summary of Material Modifications

|Download Summary of Material Modification|

Effective July 1, 2019, there will be no Prescription Drug Deductible. Please see link to Summary of Material Modification.

| Download Summary of Material Modification |

NOTICE TO PARTICIPANTS OF THE ITPEU HEALTH & WELFARE FUND

PLEASE READ CAREFULLY

WE WILL BE RELOCATING TO A NEW OFFICE BUILDING EFFECTIVE JUNE 20, 2019.  THE OFFICE WILL BE CLOSED THURSDAY, JUNE 20th AND FRIDAY, JUNE 21ST DUE TO THE MOVE.  DURING THE MOVE, THE STAFF WILL NOT HAVE TELEPHONE, FAX OR INTERNET ACCESS. PLEASE PLAN ACCORDINGLY.  THE OFFICE WILL REOPEN ON MONDAY, JUNE 24, 2019.


PLEASE NOTE OUR NEW ADDRESSES:

Physical Address:

ITPEU HEALTH & WELFARE FUND
25 Chatham Center South, Suite 100
Savannah, GA  31405

Mailing Address:

ITPEU HEALTH & WELFARE FUND
P.O. Box 18307
Garden City, GA  31418

All other contact information will remain the same.

2019 Summary of Material Modifications (PDF Format)

Free Benefit for ITPEU H&W Plan Participants and their Covered Dependents!

Effective January 1, 2019, the ITPEU H&W Plan offers telemedicine services through LiveHealth Online at NO COST to the participant and their covered family members.
 

• Connect with an available doctor in your state in just minutes from the comfort of your own home, or wherever you happen to be using the application.  No more waiting miserably in long lines at “urgent care clinics” or emergency rooms for common illnesses.  (The app is not a replacement for all medical needs.  In case of an emergency please call 911.)

For more information click Here

You can now download the ITPEU Benefit Funds app on your Android or iPhone free of charge. Go to the 

Google Play Store

or the 

App Store on your iPhone

 to download the App. The app gives you an easy way to check your benefits’ account, apply for benefits or get plan information on the app. 

SUMMARY OF MATERIAL MODIFICATIONS

To All Participants of the

ITPEU HEALTH & WELFARE PLAN

NOTICE OF CHANGE IN BENEFITS

This notice, called a “summary of material modifications,” advises you of changes in the information presented in your summary plan description (sometimes called an “SPD” or “descriptive booklet”) with respect to the ITPEU Health and Welfare Plan (the “Plan”).  Please do two things with this notice:  (1) Read it and, if you have any questions, contact the Plan Administrator and (2) keep this notice with your SPD.

This Notice is a summary of important changes to the Plan that will be effective January 1, 2017. 
 

• Click Here to Read the summary of material modifications
   
• Click here to view the chart which summarizes the modifications to your co-pays, deductibles and maximum out-of-pocket costs effective 1/1/2017

NOTICE OF CHANGE IN BENEFITS

On May 5, 2016, the Trustees of the ITPEU Health and Welfare Fund adopted important changes to the ITPEU Health and Welfare Plan.  Those changes were effective January 1, 2016, and can be summarized as follows:

1. The definition “Covered Child” described in Section 1.06 of the Plan Document now includes step-children of an Employee, provided that the Employee submits such proof of step-child status as required by the Fund Office. To have a step-child added to your coverage, please contact the Fund Office. 

2.  Section 16.05 of the Plan Document addressing “Renewability of Scholarships” was amended to reflect time spent by a student in a cooperative employment program sponsored by the college or university would not be included in the calculation of what constitutes an “additional three year period.”

TRUSTEES OF ITPEU HEALTH & WELFARE FUND REDUCE WAITING PERIOD FOR ELIGIBILITY FOR BENEFITS FROM 90 DAYS TO 30 DAYS

At a recent meeting of the Board of Trustees of the ITPEU Health & Welfare Fund, the Trustees adopted an important Amendment which reduces the time for new Employees to become Participants in the ITPEU Health & Welfare Plan and thereby become eligible for benefits. Under this Amendment all Employees of an Employer which contributes to the Health & Welfare Fund, and who become employed by such Employer on or after January 1, 2015, shall become a Participant in the ITPEU Health & Welfare Plan on the 31st day after the first day of such employment, provided they have submitted an enrollment card to the Fund office. This is a substantial reduction in the waiting period for Participant status and eligibility for benefits from the 90 day waiting period which previously was in effect.

This means that all Employees who start working on or after January 1, 2015, for an Employer which contributes to the ITPEU Health & Welfare Fund on their behalf, will be able to become eligible for benefits from the Fund on the 31st day after their first day of such employment, as opposed to having to wait 90 days for such eligibility to kick in, so long as they have submitted an enrollment card to the Fund office

This change was adopted by the Trustees pursuant to Amendment 2015-1 to the ITPEU Health & Welfare Plan Document and Amendment 2015-1 to the ITPEU Health & Welfare Plan Summary Plan Description. These Amendments can be viewed in their entirety by clicking the Amendments portion of the Fund’s Website.

SECOND NOTICE

TO ITPEU HEALTH & WELFARE FUND PARTICIPANTS REGARDING THE CYBER ATTACK ON ANTHEM BLUE CROSS BLUE SHIELD’S HEALTH INSURANCE DATABASE

(AVISO IMPORTANTE)

In our first Notice to you regarding this matter, we advised you that Anthem would be working with each affected Participant to provide credit monitoring and identity protection services without cost to the Participant. We also advised you that Anthem had created a dedicated website (www.AnthemFacts.com) which would provide information regarding this matter and would be continually updated.

Anthem has now advised us that effective Friday, February 13, 2015, current and former Anthem members whose information was included in the database that was the subject of the cyber-attack, can visit www.AnthemFacts.com to learn how to enroll in two years of free credit monitoring and identity theft repair services.

The free identity protection services provided by Anthem include two years of:
 

• Identity Repair Assistance: Should a member experience fraud, an investigator will do the work to recover financial losses, restore the member’s credit, and insure the member’s identity is returned to its proper condition. This assistance will cover any fraud that has occurred since the incident first began;

• Credit Monitoring: At no cost, Anthem members may also enroll in additional protections including credit monitoring. Credit monitoring alerts consumers when banks and creditors use their identity to open new credit accounts;

• Child Identity Protection: Child-specific identity protection services will also be offered to any members with children insured through their Anthem plan;

• Identity Theft Insurance: For individuals who enroll, Anthem has arranged for $1,000,000.00 in identity theft insurance, where allowed by law;

• Identity Theft Monitoring/Fraud Detection: For Anthem members who enroll, data such as credit card numbers, social security numbers and emails will be scanned against aggregated data sources maintained by top security researchers that contain stolen and compromised individual data, in order to look for any indication that the member’s data has been compromised; and

• Phone Alerts: Individuals who register for this service and provide their contact information will receive an alert when there is a notification from a credit bureau, or when it appears from identity theft monitoring activities that the individual’s identity may be compromised.

It is important to note that Anthem has still not been able to identify the individual Participants affected by the cyber-attack and it may yet be an additional several weeks before such information is ascertained. However, we did want to advise you that starting Friday, February 13, 2015, the dedicated Anthem Website (

www.AnthemFacts.com

) will be providing information on how to enroll into two years of free credit monitoring and identity theft repair services. 

2/12/15 - NOTICE TO ITPEU HEALTH & WELFARE FUND PARTICIPANTS REGARDING THE CYBER ATTACK ON ANTHEM BLUE CROSS BLUE SHIELD’S HEALTH INSURANCE DATABASE

As you know, the Trustees of the ITPEU Health & Welfare Fund have engaged Anthem Blue Cross Blue Shield as the Claims Administrator for all medical benefit claims under the ITPEU Health & Welfare Plan. Anthem has now advised the Trustees that on January 29, 2015, it discovered that its health insurance database, involving approximately 80 million members, had been hacked and that the cyber attackers had obtained personal information of certain Anthem members, including names, birthdates, member IDs /social security numbers, street addresses, email addresses and employment information, including income data. To date, there is no evidence that banking, credit card or medical information has been stolen.

As of this date, Anthem has not been able to identify which Participants of the ITPEU Health & Welfare Plan, if any, have been affected by this event. They estimate it will take an additional one to two weeks to make that determination. Once that information has been identified, Anthem will send written notification to the individually affected Participants. Anthem will then work with each such Participant to provide credit monitoring and identity protection services without cost to the Participant.

Anthem has created a dedicated website (www.AnthemFacts.com) and has established a dedicated toll-free number (1-877-263-7995) that you may contact to obtain information and get answers to any individual questions you may have. Anthem has assured us that the website will be continually updated as new information is received. 

In addition, Anthem has advised that they have contacted the FBI and are fully cooperating with their investigation. They have also retained one of the world’s leading cyber-security firms to assist in taking whatever action necessary to prevent this type of event from happening again.

Please be assured that the Trustees are dedicated to providing you with state-of-the-art services second to none in the employee benefit field. The database of the ITPEU Health & Welfare Plan was not the subject of any cyber-attack and remains intact. The Trustees will continue to actively monitor this matter on your behalf to make certain that every possibly action is taken to prevent any Plan Participant from being harmed by this event and to ensure that Anthem takes every appropriate action to prevent any security breaches in the future.

This Notice is a summary of important changes to the Medical Plan that will become effective July 1, 2014.

Modifications of Medical Benefit Program Effective July 1, 2014

1.         Modification for all Participants

            When a contributing Employer becomes delinquent in its contributions to the Plan, the payment of benefits to all Employees of such Employer and their Covered Family Members shall be suspended for all claims incurred 40 or more days after the date such contributions were due.  Such suspension shall remain in effect until payment of such delinquent contributions is received by the Fund Office.  

            Thus, effective July 1, 2014, instead of the Plan paying benefits during the first two months that an Employer’s contributions are delinquent, and suspending payment of such benefits for any claims incurred after such two month period, the Plan will now pay benefits for the first 40 days of such period of delinquency and suspend payment of any benefits incurred thereafter until such time as the Employer is no longer delinquent.

2.         Notice to be Sent to All Affected Participants

            The Trustees will send written notice to the Employees of a delinquent Employer within 10 days after the date the contributions in question were due, advising such Employees that payment of their benefits, and the benefits of their Covered Family Members, will be suspended in 30 days due to lack of payment of contributions by their Employer, unless the Employer pays all contributions due and owing within such 30 day period.  The notice will state the actual date of suspension of benefits.  Copies of the Notice will be sent to the Employer, applicable Contracting Officer, and DOL wage & hour area Director.

SUMMARY OF MATERIAL MODIFICATIONS TO YOUR MEDICAL BENEFITS EFFECTIVE JANUARY 1, 2014