H&W: What’s New in 2020

Changes Ahead For Life/Dental/Vision Coverages

The Board of Trustees of the Professional Musicians, Local 47 and Employers’ Health & Welfare Fund (the “Fund”) is committed to providing the best health insurance delivery and cost platforms available to the Fund’s participants. In furtherance of that goal, and as reviewed in this article, the Fund has modified its benefit plan menu with reference to the Fund’s Life Insurance, Dental Insurance and Vision Insurance Plans.

Modifications to the Life Insurance Plan for 2020

As of January 1, 2020, to be enrolled and have coverage through the Fund’s Life Insurance/Accidental Death & Dismemberment Plan (the “Life Insurance Plan”), a Participant must complete, date, sign and turn-in to the Fund’s Administrative Office any required Beneficiary Form (and/or any other forms and documents required by the carrier). Any Participant who does not have a fully completed Beneficiary Form on file with the Fund’s Administrative Office as of January 1, 2020, will not be enrolled or covered by the Fund’s Life Insurance Plan.

This means – as of January 1, 2020 – that if you are a Participant and you do not complete, date, sign and turn-in to the Fund’s Administrative Office the required Beneficiary Form, you and your beneficiaries will not be entitled to benefits from the Fund’s Life Insurance Plan. Only the named beneficiaries of those Participants who do timely file a properly completed Beneficiary Form will be entitled to make a claim for benefits under the Fund’s Life Insurance Plan.

Presently, the Fund’s Life Insurance Plan is administered and funded through a group insurance policy issued by Prudential Insurance Company of America (“Prudential”). All claims for benefits under the Fund’s Life Insurance Plan are governed by the terms set forth in the Prudential policy and must be submitted to Prudential for review and processing. The Trustees of the Fund reserve the right to change carriers and/or to modify the terms of the Fund’s policy with Prudential.

Vision / Dental Plan Enrollment Changes for 2020

Starting with the coverage period effective January 1, 2020, a Participant that qualifies – based on Employer contributions remitted during the prior Qualifying Year (here; October 2, 2018 – October 3, 2019) – for “Level A” or “Level B” coverage, may waive the Medical portion of the coverage and enroll in Dental and Vision only. In order to be entitled to benefits/coverage from the Dental Plan and the Vision Plan, the Participant must also properly complete the required Enrollment Form and timely file that with the Fund’s Administrative Office. Failure to timely and fully complete the Enrollment Form, and make any premiums due, will impact the Participant’s ability to obtain Dental Plan and Vision Plan benefits.

A new Dental/Vision Only form has been created for those Participants that qualify at “Level A” or “Level B” and who want to waive Medical coverage and enroll only in the Fund’s Dental/Vision benefits.

Participants who qualify for enrollment in the Fund’s Medical Plan at “Level C” coverage are not eligible to enroll in either the Dental Plan or the Vision Plan.

Presently, the Fund’s benefits and group insurance carriers are: Life and Accidental Death and Dismemberment benefits (provided through Prudential Life), Medical benefits (provided through Blue Shield and Kaiser Permanente), Dental benefits (provided through Delta Dental of California and DeltaCare USA), Chiropractic/Acupuncture benefits (provided through Landmark Healthplan) and Vision benefits (provided through Gerber Life and administered by MES Vision) (collectively the “Carriers”). All claims for benefits are governed by the terms set forth in the Carrier’s policies and must be submitted to the applicable Carrier for review and processing. The Trustees of the Fund reserve the right to change Carriers and/or to modify the terms of the Fund’s policy with the Carrier.

The New Applicable Benefit Forms For 2020

* Effective January 1, 2020, you will not have Life and AD&D coverage unless you return a beneficiary form to indicate that you are enrolling in the Fund’s Life and AD&D program through Prudential Life Insurance Co.

** New for January 1, 2020, the Fund is offering a Dental/Vision benefit; you do not have to enroll in a medical plan to have a dental/vision benefit. This option is available to those who qualify at Levels A & B. A premium may be required.

*** The full benefit package is not only medical coverage, but includes the option to add dental and vision, if you have qualified at Levels A & B.

As always, check out the Fund’s website for FAQs; and the Fund’s administrative staff are there to help you as well!

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