2008 Medical Plan Changes

Please take a few uninterrupted moments to read this notice carefully.  It contains important information about changes to your medical insurance benefits.

Overview

The Trustees have changed the name of the Plan in order to accurately reflect the broad spectrum of benefits being offered to its participants. The St. Paul Electrical Construction Medical Reimbursement Plan is now the St. Paul Electrical Workers Health Plan (The Health Plan).

Following an analysis for claims-cost projection and the premium increases required by BCBS, the Trustees have determined to discontinue the fully-insured BCBS program and change to a self-insured program, while maintaining the benefit schedule offered under the fully-insured program with some changes as noted below.

Specific Changes and Effective Dates

On July 1, 2008 the Health Plan will go to self-insured medical benefits.  Being self-insured means the Health Plan is not subject to state mandated benefits, however, most benefits offered under the fully-insured BCBS plan remain.

Claims administration, payments and member services for benefits will continue to be provided by BCBS.  All questions for benefits and claims should be directed to BCBS at 651-662-4539 or 1-866-477-1587.

The Plan office will administer eligibility for all covered members and their dependants including student dependents.  All questions on eligibility should be directed to the Plan office at 651-776-4239 ext 7758 or 1-888-439-4239 ext 7758.

Student dependent coverage requirements will remain the same under the self-insured program.  A dependant child between the ages of 19 through 24 may remain covered under the Health Plan if attending a college, university or trade school with a defined course of study on a full time (12 credits) basis, or if the child is properly enrolled, accepted and awaiting entry at an approved school.

Deductibles for the Health Plan will increase effective July 1, 2008 as noted below.  Any expenses applied toward the deductible for claims between January and June 2008 will be credited toward satisfying the July 1, 2008 deductible.

Out-of-pocket maximum limits (OOP) will increase effective July 1, 2008 as noted below.  Any expenses applied toward the OOP for claims between January and June 2008, will be credited toward satisfying the July 1, 2008 OOP maximum.

What to Expect Next

All participants and dependents will be issued new identification (ID) cards for the changes becoming effective on July 1, 2008.  You must use the new ID cards for all services received on and after July 1, 2008.

Whether you have already paid some or all of the 2008 deductible and OOP or none at all, and if you receive medical services on and after July 1, 2008 the new deductible and OOP limits will apply; however any expenses applied for services between January to June 2008 will be credited toward the new limits.

In the next few days you will receive a Family Information Statement from the Plan office.  This form is being sent out to gather and update dependent eligibility, coordination of benefits information, marital status and general census information the Plan office uses to maintain coverage for you and your family.  You will be required to identify all dependents, including student dependents, confirm any other coverage available for your family and update general information.  A full explanation of what will be required will be included with the form.

If you have questions regarding this notice contact the Health Plan Office at 651-776-4239 ext 7758.