Effective April 1, 2019 Out-Patient Out-of-Network Providers will no longer be covered
Effective April 1, 2019 all outpatient expenses incurred at facilities that are not In-Network (not participating in any BCBS Association affiliate or
BlueCard network of preferred providers) will no longer be covered.Therefore, there is no out-patient out-of-network benefit available. The plan
continues to cover out-of-network chiropractic and Emergency Medical Conditions, including ambulance, as defined in the Summary of Material Modification.
Click here to view the Summary of Material Modification that was mailed to participants for more information on this change.
New Medicare Medical ID Cards
As of January 1, 2019 all Medicare Retiree Participants should have received new Medical ID Cards. Please remember to show these cards to your provider. As a reminder, all participants DID NOT receive new Medicare BlueRX prescription ID cards and you will need to keep the card you currently have. If you did not receive a new medical ID card please contact the Blue Cross Blue Shield customer service number on the back of your old ID card.
Click to view examples of the new Medical ID cards.
IMPORTANT INFORMATION
Regarding Your Medicare Plan
Dear Local 49 Medicare Participants,
By now, most of you are aware that recent legislation passed by Congress has impacted the Fund’s Medicare program resulting
in plan changes for many of you effective January 1, 2019. The good news is, being part of the Operating Engineers Local
49 Health Plan, you DO NOT need to take any action or enroll in any new plan if you wish to stay with the Operating Engineers
Local 49 Health and Welfare Fund Medicare eligible coverage.
The Local #49 Health and Welfare Fund has sent individual letters to each Medicare participant detailing any changes to your plan.
Please open and read these letters. The letters also include your monthly premium rate effective March 1, 2019.
The Operating Engineers Local 49 Health and Welfare Fund will also be hosting informational Medicare meetings for those participants
transitioning from the Group Platinum Blue (Cost) Plan to the Group Senior Gold (Supplement) Plan. At the meetings, we will discuss
the changes to your plan. Click here to view a list of the Medicare meetings and RSVP information.
Please plan to attend a meeting close to you.
Lastly, those participants transitioning from the Group Platinum Blue (Cost) Plan to the Group Senior Gold (Supplement) Plan will receive
a new Senior Gold medical ID card and Plan information sometime in December and you can begin using the card January 1, 2019. However,
you will continue to use your current MedicareBlue Rx ID card for prescription drugs.
Complete your Health Dynamics Physical by Nov. 30, 2019 to get your deductible waived!
Complete your Health Dynamics Physical by Nov. 30, 2019 or you will have a deductible next year. You and/or your spouse will have a deductible next year if you do not complete a
Health Dynamics Physical any time by Nov. 30, 2019. Call 1-866-443-0164 to schedule an appointment at a Health Dynamics site near you.
Click here for more info.
Changes to Contribution Allowance for Retiree Health Coverage
For all participants who are eligible for retiree coverage and enter the retiree health plan on or after January 1, 2018,
the previous maximum of 30 total service credits will not apply. The total number of potential service credits will now
be unlimited. These credits are used to calculate your contribution allowance which reduces your self-pay premium when
you retire. Elimination of the 30 total service credit cap for those who retire on or after January 1, 2018 may give
rise to situations where a participant’s contribution allowance exceeds their self-pay premium rate. In that situation,
those participants will not have a monthly premium due, however in no event will a retiree receive additional credit for
unused or excess contribution allowances.
In addition, Bargaining Premium participants who enter the retiree health plan on or after January 1, 2018,
will be credited with 1.2 service credits for each calendar year he or she was covered by the Health and Welfare Fund.
Please see the example of both these changes in the Summary of Material Modification.
Click to view the Summary of Material Modification.
New Employee Portal!
The new employee health portal allows you to access information about your hours and eligibility, Health Reimbursement Arrangement (HRA) balance, and claims history.
This portal is for employees only, spouses and dependents do not have portal access.
Click here to register.
Medicare Part B Enrollment Reminder.
The transition from active employment to retired status can present challenges. One of these
challenges is deciding when to enroll for Medicare Part B coverage.
This notice is intended to assist participants as they transition from an active employee covered by the 49ers
Plan, to an early retiree covered under the Retiree portion of that Plan, and finally, to a Medicare enrollee also
covered by a supplemental plan offered through the 49ers Plan. The notice serves as a reminder of the
requirements of the Plan, as well as Medicare, during this transition process.
In general, you should enroll in Medicare Part B when you are first entitled to do so. Click here for more information.
The Medicare Part B Enrollment also applies to those participants who are on Medicare due to a disability.
New Health Dynamics Physical Option
Effective January 1, 2017, participants and spouses who prefer to see their own physician for their annual physical examination versus participating in the Health Dynamics Comprehensive physical program may participate in the Health Dynamics Primary MD program!
Participants and spouses utilizing the Primary MD program are eligible for EITHER:
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- A $20 per month gym/health club membership reimbursement for up to 12 months ($240 for the participant and an additional $240 for their spouse if each participates); or
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- Reimbursement for copayments, deductibles and coinsurance out-of-pocket expenses incurred under the medical plan up to $240 per participant and an additional $240 for their spouse if each participates.
Call Health Dynamics at 1-866-443-0164
Click here for more information.
Click here to watch a short video about the Health Dynamics Primary MD Program.
Enhancements to the Plan (Summary of Material Modifications):
These Summary of Material Modifications (SMM) describe changes that have been made to the Plan by the Board of Trustees. The SMMs included below modify the 2014 Summary Plan Description (SPD).
Click
here to view a list of all Plan Enhancements.
Healthier Living Articles:
Click here to get you and your family on the Road to a Healthier You by learning dynamic new ways to Take Control of Your Health!