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2021 - NAS METAL TRADES WELFARE FUND BENEFIT ANNOUNCEMENT - (1/6/2021)

December 2020

To All Participants in the NAS Metal Trades Welfare Fund

From the Board of Trustees

 

Retirement of Fund Administrator

It’s with a debt of gratitude that we announce the retirement of long time Fund Administrator, Michael Jacobson. Mike has been with the NASMT Trust Funds for over 40 years and has led the organization for more than 35 years. He has always guided the Trust Funds with the utmost professionalism and with the best interest of the participants in mind. We wish Mike all the best in retirement and thank him for his exceptional years of service.

Mike will be replaced by the Assistant Fund Administrator, John Eger. John has been with the Trust Funds for more than 37 years. We are confident that he will continue the legacy that Mike has built.

The Fund Remains Financially Stable

There are three Plans of Benefits provided by the National Automatic Sprinkler (“NAS”) Metal Trades Welfare Fund. The contribution rate for each of these Plans of Benefits was set effective September 1, 2014, and has not increased since that time. The current contribution rates are as follows:

• Plan A $5.10 per hour
• Plan B $4.80 per hour
• Plan C $4.25 per hour

These contribution levels continue to support the benefits of each plan. Additionally, investment returns on Fund reserves have been positive so far this year, and the hours worked for which contributions are made to the Fund have continued to increase over previous recent years.

Moreover, claim expenses have been lower than was expected. While there is no expectation that the Fund will need to increase these contribution levels in the near future, the Trustees evaluate the Fund’s financial condition on an annual basis and determine the appropriate contribution rates.

REMINDERS

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 NAS Metal Trades Welfare Fund when using an In-Network provider.

COVID-19 Vaccine Coverage

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and its corresponding regulations require the Fund to fully cover in-network and out-of-network qualifying coronavirus preventive services within 15 days of their identification by the United States Preventive Services Task Force or the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. These preventive services are expected to include FDA-approved COVID-19 vaccines developed for widespread distribution through Operation Warp Speed and the private sector.

Therefore, upon designation by one of these federal agencies that a COVID-19 vaccine, and/or other items or services, are qualifying coronavirus preventive services, the Fund will provide full coverage within 15 days of the agency’s announcement. This means there should be no out-of-pocket costs for you or your family for such qualifying coronavirus preventive services. For out-of-network qualifying coronavirus preventive services, the Fund will reimburse the provider at the applicable Medicare rate.

Retiree Benefits and Medicare

Medicare is the primary coverage for retirees, dependents of retirees, and beneficiaries. The NAS Metal Trades Welfare Plan requires that individuals who are eligible for Medicare Part B benefits sign up for those benefits. Additionally, if an individual is not entitled 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.

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

The NASMT Welfare Plan, as required by the Women’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 complications resulting from a mastectomy, including lymphedema.

Call the Fund Office at 1-800-638-2603 for more information.

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 advance to you, and deducting such amounts from benefits which become due to you until the entire amount of benefits erroneously paid is recovered.

Call the Fund Office at 1-800-638-2603 for more information.

Blue Distinction Center

Remember to take advantage of Blue Distinction Centers. The Blue Cross Blue Shield (“BCBS”) Association has identified specific hospitals across the nation that have demonstrated expertise in delivering specialty care. Some of these facilities are close to where you live. The BCBS evaluation process involves reviewing the expertise of the medical team, the number of times the facility has performed the procedure, and the facility’s track-record for procedure results. Facilities identified as “Blue Distinction Centers” have a proven track- record for delivering better results such as fewer complications and fewer readmissions than facilities not recognized as Blue Distinction Centers.

Blue Distinction Centers delivering the following types of specialty care have been identified:

• Bariatric Surgery
• Cardiac Care
• Knee and Hip Replacement
• Maternity Care
• Spine Surgery
• Transplants

If you or someone in your family is contemplating a procedure (e.g. surgery, delivery) in one of the above medical categories, the Board of Trustees encourages you to consider doing so at a facility that specializes in that care. Finding the right facility can have a direct impact on the care you receive and the results of your procedure, including better medical outcomes, fewer complications, less readmissions for the same condition, lower hospital-acquired infection rates, and lower mortality rates. Better care is better for you and will likely result in lower medical costs to you and the Fund.

Some of the facilities identified as Blue Distinction Centers also have lower costs associated with their high-quality care. Facilities that are considerably more efficient at providing expert specialty care have been further classified as “Blue Distinction Centers +”.

Blue Distinction Center Finder
Use the “Blue Distinction Center Finder” link on the Welfare Fund’s website, www.nasifund.org. You can search for the particular specialty you need (e.g. cardiac care), and you can limit your search to the state or states you are willing to go to in order to receive the best care available.


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