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NAS Metal Trades Welfare Fund Benefit Changes for 2015 - (11/1/2014)

To All Participants in the NAS Metal Trades Welfare Fund

From the Board of Trustees

In recent years, the National Automatic Sprinkler Metal Trades (“NASMT”) Welfare Fund has been financially struggling. Before this year, expenses have been consistently exceeding income and the assets of the Fund have been dwindling. The combination of deep benefit cuts imposed effective January 1, 2013, along with a $0.50 per hour contribution rate increase effective September 1, 2013, finally brought the finances of the plan back in balance.  Projections, however, showed deficits returning in 2015 if no additional changes (to the contribution rate or to the benefits) were made.

In response to the benefit cuts imposed as of January 1, 2013, the Board of Trustees has heard from participants, employers and local unions seeking improvements in the existing benefit levels. To address the benefit improvement request along with the prospect of returning financial deficits, the Trustees decided that, effective September 1, 2014, the contribution requirement for each level of coverage was to be increased by $0.60 per hour.

Because of the increased level of contribution income, the Board of Trustees are now able to announce the following benefit levels that are effective beginning January 1, 2015.

Plan A In-Network Benefits
Annual Deductibles
Individual $ 750
Family $1,500
Out-of-Pocket Maximums
Individual $6,100* Family $12,200*
Prescription Out-of-Pocket Maximums
Individual $ 500
Family $1,000

* (this amount includes the deductible)

Plans B and C In-Network Benefits
Annual Deductibles
Individual $1,250
Family $2,500
Out-of-Pocket Maximums
Individual $6,100* Family $12,200*
Prescription Co-insurance
Preferred Brands and generics 70% Non- Preferred Brands 60%
Prescription Out-of-Pocket Maximum
Individual $ 500
Family $1,000

* (this amount includes the deductible)

Plan A will continue to have medical co-insurance with the Plan paying 70% on covered expenses for In-Network providers and 55% on out-of-network providers.

Plan B will continue to have medical co-insurance with the Plan paying 70% on covered expenses for In-Network providers and 50% on out-of-network providers.

Plan C will continue to have medical co-insurance with the Plan paying 65% on covered expenses for In-Network providers and 50% on out-of-network providers.

Flu shots and other Immunizations
Remember to get your seasonal flu shot from your Blue Cross Blue Shield participating physician or at your local pharmacy that participates with Express Scripts. Most immunizations, including flu shots are covered at 100% by the NASMT Welfare Fund when using an In-Network provider.
Many more people will die this year from influenza than from Ebola. We can do something about flu – be smart and get the immunization.

REMINDERS

Retiree Benefits and Medicare

Medicare is the primary coverage for retirees, de- pendents of retirees and beneficiaries. The NASMT Welfare Plan requires that individuals who are eligi- ble for Medicare Part B benefits sign up for those benefits. Additionally, if an individual is not enti- tled to cost-free Medicare Part A, that individual must also purchase Part A coverage from Medicare when they become eligible to do so at age 65.

Notification Requirement upon Divorce

Notice of your divorce must be provided to the Fund office within 60 days of your divorce.
If notice of your divorce is not provided to the Fund Office in this time frame, and as a result, benefits are paid to an ineligible dependent, the Fund can recover those benefits by treating such benefits as an ad- vance to you, and deducting such amounts from ben- efits which become due to you until the entire
amount of benefits erroneously paid is recovered.

Annual Reminder regarding Women’s Health and Cancer Rights Act of 1998

The NASMT Welfare Plan, as required by the Wom- en’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and com- plications resulting from a mastectomy, including lymphedema. Call the Fund Office at 1-800-638- 2603 for more information.

Summary of Benefits and Coverage

The pages that follow this announcement are designed to meet requirements of the PPACA.   Please see the full document and CLICK HERE.

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