Anthem Breach (Posted February 2015)
Anthem is working with All Clear ID to provide members identity protection services in response to the recent breach. Anyone who has been eligible with Anthem since 2004 will automatically be enrolled in their Identity Repair coverage for 24 months. If you suspect any type of identity theft, simply call All Clear ID and let them do the work to restore your identity and credit report.
Anthem is also providing other services at NO cost through All Clear ID. However, you must sign up for these services since you need to provide personal information and give consent to be enrolled. These services include: Identity Theft Monitoring, Credit Monitoring, Secure Alerts, Lost Wallet Protection, Theft Insurance, and Child Identity Protection. To start the enrollment process go to https://anthem.allclearid.com/ or call 1-877-263-7995. If you take this initial step online, you will receive an email from All Clear ID within 72 hours to complete your enrollment process. If you call, you will give them your contact information and will receive a return call within 72 hours to complete the process.
Anthem suffered a major external data breach. They are still calculating how many records were accessed, but the number may reach as high as 80 million current and former members of Anthem. The data that was accessed included names, addresses, social security numbers, birth dates, etc. The data does not appear to have contained medical or credit card information.
It appears Anthem is prepared to do everything it can to mitigate the damage caused by the breach. They will be notifying all affected individuals in the coming weeks and will offer identity theft protection to them. If you have questions or concerns about this breach, please refer to Anthem, either via its breach website (www.anthemfacts.com) or its breach-dedicated toll-free number (1-877-263-7995).
2015 New Insurance Plan Limits (Posted December 2014)
Starting in 2015, the Affordable Care Act (ACA) limits the out-of-pocket expenses an individual can incur for in-network essential health benefits (deductible, copayments, and coinsurance), prescription copayments, and vision examination copayments to a combined total of $6,600* ($13,200 per family). This change will help the members and families with the highest medical and prescription expenses save money by limiting the amount they can potentially be responsible to pay. The following changes will go in effect January 1, 2015 to incorporate this ACA provision into the Insurance Plan:
Eliminate the current Annual Out-Of-Pocket Maximums of $2,250 per person/$4,500 per family (limits doubled for out-of-network claims). The current Annual Out-Of-Pocket Maximums do not include deductibles or copayments
Establish new Maximum Out-Of-Pocket (MOOP) Limits of $3,000 per person and $6,000 per family (limits double for out-of-network claims) per calendar year. The MOOP Limits will include deductibles, copayments, and coinsurance (but not penalties, balance billings, etc.). Prior to this change, there were no limits to the amount an individual could owe for copayments. If these limits were in place in 2013, over 250 people would have saved money on medical expenses.
Prescription Drug Benefits
Establish MOOP Limits of $3,575 per person and $7,150 per family per calendar year. The MOOP Limits will NOT include penalties, ingredient charges, etc. Currently, there are no limits to the amount an individual can be charged for prescriptions in a calendar year.
Establish MOOP Limit of $25 per person and $50 per family per calendar year. This limit only applies to the examination copayment and purchase of standard frames and lenses. Additional costs for upgraded frames, lenses, and contacts are not included in the limit.
*The $6,600 combined MOOP Limit established by the ACA is subject to change annually. Any future increases in the combined MOOP Limit shall be split evenly between the medical and prescription limits listed.
Bonus Checks Issued to Retirees! (Posted May 2014)
Great news for retirees: The Board of Trustees for the LDC&C Pension Fund of Ohio recently approved a one-time bonus check for retirees. This is the first increase or extra monies the retirees have received since 2007. The bonus check was issued to eligible members and beneficiaries in May. The bonus check was equal to the lesser of $1,200 or the pensioner’s regular monthly payment.
To be eligible for the bonus check, benefit recipients had to have a pension effective date of December 2013 or earlier, be entitled to receive a pension benefit for the month of April 2014, and be living on the date of payment of the bonus check. Thanks to all retirees for making the Fund and the trade what it is today. We wouldn’t be here without you and your hard work and sacrifice.
COBRA Rate Increase Notification (Posted May 2014)
Once a member establishes eligibility with the OLDC-OCA Insurance Fund and is then in danger of losing eligibility due to a period of unemployment or insufficient working hours, the member may make payments under COBRA to maintain coverage.
Class 1 members (actives) may continue to participate in the Insurance Plan for a maximum of eighteen (18) months. Disabled members, who meet the requirements under the Plan, may continue to participate in the Insurance Plan for a maximum of twenty-nine (29) months. Under the Class 1 Program, the first twelve months of payments are calculated on the least number of hours necessary to maintain eligibility under the Plan multiplied by the hourly insurance contribution rate. The monthly amount to continue eligibility for the remainder of the months is at a fixed rate.
The Board of Trustees reviews this fixed COBRA rate annually. Upon review, the rate is adjusted based on the actual and projected claim costs and administrative expenses. Effective July 1, 2014 this fixed COBRA rate will be increased to $866.00 per month and $1,274.00 per month for extended eligibility due to disability. The previous rates were $803.00 and $1,181.00, respectively.
In addition, by notifying the OLFBP Fund Office within 60 days of a qualifying event, a covered spouse or eligible dependent may qualify to continue coverage under the Plan for a maximum of thirty-six (36) months. The cost to continue eligibility is based on the same fixed monthly rate.
If you are in the Retiree Insurance Program, this rate change does NOT affect your monthly retiree insurance rate.
Scholarships Available (Posted February 2014)
OLFBP is pleased to announce the renewal of the Ohio Laborers Future Leaders of America Scholarship for a fifth year. Please note, the deadline is March 31, 2014 at 5p.m. For full details of the scholarship and how to apply, please click HERE.
Children and grandchildren of active members in good standings are eligible to receive up to $1,000 this year. The scholarship may be renewed for up to three additional years. Eligibility includes a minimum 3.0 cumulative GPA and full-time enrollment or planned enrollment in a post-secondary course of study for vocational or technical training certification or degree at an eligible education institution.
Insurance Plan Changes (Posted December 2013)
The Board of Trustees for the OLDC-OCA Insurance Fund recently approved changes to the Plan that may affect you:
Clinical Trials - The Affordable Care Act (ACA) prohibits a group health plan (1) from denying a qualified individual from participating in an approved clinical trial with respect to the treatment of cancer or another life-threatening disease or condition; (2) from denying, limiting, or imposing additional conditions on the coverage of routine patient costs for items and services furnished in the connection with participation in the trial; and (3) from discriminating against the individual on the basis of the individual’s participation in the trial. Due to this provision of the ACA, the following General Plan Exclusions and Limitations in the Summary Plan Description have been updated effective January 1, 2014 as follows:
Exclusion #4: Experimental or Investigational drugs, devices, medical treatments, or procedures, except where costs for these items and services are provided in connection with participation in a clinical trial and federal law requires these items and services be covered.
Exclusion #84: Services, supplies, or other expenses associated with a clinical trial program, unless the Fund is prohibited from denying coverage for such services, supplies, or other expenses under federal law.
Retirees and Dependents of Retirees Under Age 65 and Medicare Eligible Moving to NEBCO - Effective January 1, 2014, retirees and dependents of retirees who are under age 65 and Medicare eligible will be moving from Anthem to NEBCO for their secondary coverage for medical claims. Any member who is affected by this change, will be contacted by direct mail from both the OLFBP Fund Office and NEBCO. If you are not familiar with NEBCO, they already handle the secondary medical claims for retired members and their dependents over age 65.
Orchard Specialty’s Bridge Program - The OLDC-OCA Insurance Fund is launching a new cost savings program in coordination with Orchard Specialty’s Bridge Program starting December 1st, 2013. Many of the specialty medications with the highest cost have manufacturer sponsored co-pay programs that help reduce the cost of the medication. The Bridge Program is designed to help both members and the Fund take advantage of these savings opportunities. Any member who is taking a medication in the Bridge Program will be contacted directly by Orchard Specialty both in writing and via the phone to help explain the details of the program and assist with enrollment.
Marketplace Employee Notice (Posted August 2013)
The Patient Protection and Affordable Care Act (PPACA), commonly referred to as Health Care Reform or Obamacare, requires all employers to send notices to all employees regarding the upcoming Health Insurance Marketplace. (The Marketplace was originally referred to as health care exchanges.) The notice (New Health Insurance Marketplace Coverage Options and Your Health Coverage) must be sent to all employees no later than October 1, 2013 and to any new employees hired after October first at the time of hiring.
This notice is simply designed to inform you of the upcoming Health Insurance Marketplace, which was originally referred to as exchanges. Members are not required to do anything in response to this notice, it is informational only. Please note, the exchanges are not designed to replace existing employment-based insurance plans like the plan available through the Ohio Laborers’ District Council – Ohio Contractors’ Association Insurance Fund. The intent of the Marketplace is to give the uninsured multiple options when looking for health insurance. If you and your dependents have and maintain insurance coverage, you will not need to do anything with the exchanges. If you lose eligibility with the OLDC-OCA Insurance Fund, you will be able to purchase coverage through the exchanges starting in 2014.