Chicago Regional Council of Carpenters Welfare and Pension ... 2012 News_156.pdf · Managing your...
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Union Trustees Frank T. Libby Jeffrey Isaacson Keith Jutkins Joseph Pastorino Gary Perinar, Jr. Thomas E. Ryan, Jr. Bruce Werning Employer Trustees J. David Pepper Benjamin A. Johnston Paul R. Hellermann Roger A. Monaco Gerald W. Thiel, Jr. Todd H. Harris Summer 2012 Managing your oral health also means taking control of the proposed dental treatment plan and associated cost. Before you agree to any treatment plan beyond your routine cleaning and check-up, be sure you are aware of the specific services included in the proposed treatment plan and what your out-of-pocket cost will be. If the proposed treatment plan will exceed $200, request that your dentist submit to Delta Dental a request for a predetermination of benefits estimate. Obtaining a predetermination of benefits estimate is easy: • Ask your dentist to submit a claim form with the proposed treatment plan to Delta Dental of Illinois Customer Service Dept. Your dentist’s office staff will be familiar with the process. • Delta Dental will review the level of benefits available under the Plan and provide you with a predetermination of benefits estimate. It will tell you and your dentist exactly what the Plan will cover and what your out-of-pocket expense will be. Avoid that “sticker shock”– request a predetermination of benefits before treatment! The deadline for completion of your on-line Participant Information Form has been extended to June 30, 2012. Whether you are single, married or divorced, with or without dependent children you need to complete an on-line form. If you do not complete your on-line form by June 30, 2012, medical claims for you and your family members will be denied and you will be responsible for payment to your physician and hospital. Complete the form on-line at: https://verify. secova.com/CRCCWFPIF. You will need your unique ID (found on your BCBSIL ID card) and your date of birth for initial log in. Questions or need a paper form? Call Secova toll free, Monday -Friday from 8:00 a.m. to 6:00 p.m. (CST) at 1-877-632-8127. Chicago Regional Council of Carpenters Welfare and Pension Funds YOUR DENTAL BENEFIT For many years, we have been pleased to provide our members with benefits to support their dental care needs. In April 2010, we partnered with Delta Dental to provide you with access to high quality providers and negotiated discounts to help make your benefit dollars go farther. In this newsletter, we will explore the benefits of your dental plan: • Why everyone should maintain excellent oral hygiene; • How to avoid “sticker shock” by using the predetermination of benefits program; • What additional resources are available online at www.deltadentalil.com; and • Why using in-network providers is the best financial decision for you and the Fund. Save Money – Use Network Dental Providers Our contract with Delta Dental PPO & Premier Network Programs gives you access to the nation’s largest network of dentists. Because these dental providers have agreed to discount their fees, using an in-network Delta Dental provider saves money for you and the Fund. In addition, our Plan uses Delta Dental’s allowable charge amount as the maximum plan allowance for in-network expenses. Therefore, in-network providers will not “balance bill” you for amounts in excess of the maximum plan allowance. Out-of-network providers can “balance bill” you for charges exceeding Delta Dental’s maximum plan allowance. In-network providers cannot. Also in-network providers should only bill you for your coinsurance and deductible amounts. Most out-of-network providers require full payment at time of service. Example of how to save using the in-network benefit Let’s say you get three fillings. This is a basic care service under the Plan, and paid at 80% after you satisfy the $50 annual deductible. We will assume that Delta Dental’s allowed amount is $240 for this service and that you’ve met the deductible already. As you can see in the example on the right, using the in-network provider saves money for both you and the Fund every time! In-Network Out-of-Network Using an in-network PPO provider, your out-of- pocket cost is only $48 (20% of the $240 allowed charge). Using an out-of-network provider who charges $330 for the same three fillings; your out-of- pocket cost would be $138 Why? The Plan considers $240 as the allowed amount, and pays 80%, or $192. You are responsible for the remaining 20% ($48) plus the $90 balance between $240 and $330 – for a total of $138. FINAL REQUEST!! Your medical coverage will terminate if you do not complete your on-line Participant Information Form by June 30, 2012.
Transcript of Chicago Regional Council of Carpenters Welfare and Pension ... 2012 News_156.pdf · Managing your...
,
Union Trustees Frank T. Libby Jeffrey Isaacson Keith Jutkins Joseph Pastorino Gary Perinar, Jr. Thomas E. Ryan, Jr. Bruce WerningEmployer Trustees J. David Pepper Benjamin A. Johnston Paul R. Hellermann Roger A. Monaco Gerald W. Thiel, Jr. Todd H. Harris
Summer 2012
Managing your oral health also means taking control of the proposed dental treatment plan and associated cost. Before you agree to any treatment plan beyond your routine cleaning and check-up, be sure you are aware of the specific services included in the proposed treatment plan and what your out-of-pocket cost will be.
If the proposed treatment plan will exceed $200, request that your dentist submit to Delta Dental a request for a predetermination of benefits estimate.
Obtaining a predetermination of benefits estimate is easy:
• Ask your dentist to submit a claim form with the proposed treatment plan to Delta Dental of Illinois Customer Service Dept. Your dentist’s office staff will be familiar with the process.
• Delta Dental will review the level of benefits available under the Plan and provide you with a predetermination of benefits estimate. It will tell you and your dentist exactly what the Plan will cover and what your out-of-pocket expense will be.
Avoid that “sticker shock”– request a predetermination of benefits before treatment!
The deadline for completion of your on-line Participant Information Form has been extended to June 30, 2012. Whether you are single, married or divorced, with or without dependent children you need to complete an on-line form. If you do not complete your on-line form by June 30, 2012, medical claims for you and your family members will be denied and you will be responsible for payment to your physician and hospital.
Complete the form on-line at: https://verify.secova.com/CRCCWFPIF. You will need your unique ID (found on your BCBSIL ID card) and your date of birth for initial log in.
Questions or need a paper form? Call Secova toll free, Monday -Friday from 8:00 a.m. to 6:00 p.m. (CST) at 1-877-632-8127.
Chicago Regional Council of Carpenters Welfare and Pension Funds
YoUR DEnTAl BEnEFIT For many years, we have been pleased to provide our members with benefits to support their dental care needs. In April 2010, we partnered with Delta Dental to provide you with access to high quality providers and negotiated discounts to help make your benefit dollars go farther. In this newsletter, we will explore the benefits of your dental plan:
• Why everyone should maintain excellent oral hygiene;
• How to avoid “sticker shock” by using the predetermination of benefits program;
• What additional resources are available online at www.deltadentalil.com; and
• Why using in-network providers is the best financial decision for you and the Fund.
Save Money – Use Network Dental ProvidersOur contract with Delta Dental PPO & Premier Network Programs gives you access to the nation’s largest network of dentists. Because these dental providers have agreed to discount their fees, using an in-network Delta Dental provider saves money for you and the Fund. In addition, our Plan uses Delta Dental’s allowable charge amount as the maximum plan allowance for in-network expenses. Therefore, in-network providers will not “balance bill” you for amounts in excess of the maximum plan allowance. Out-of-network providers can “balance bill” you for charges exceeding Delta Dental’s maximum plan allowance. In-network providers cannot. Also in-network providers should only bill you for your coinsurance and deductible amounts. Most out-of-network providers require full payment at time of service.
Example of how to save using the in-network benefitLet’s say you get three fillings. This is a basic care service under the Plan, and paid at 80% after you satisfy the $50 annual deductible. We will assume that Delta Dental’s allowed amount is $240 for this service and that you’ve met the deductible already.
As you can see in the example on the right, using the in-network provider saves money for both you and the Fund every time!
In-network out-of-network
Using an in-network PPO provider, your
out-of- pocket cost is only
$48 (20% of the $240 allowed charge).
Using an out-of-network provider who charges $330 for the same three fillings;
your out-of- pocket cost would be
$138 Why? The Plan considers $240 as the
allowed amount, and pays 80%, or $192. You are responsible for the remaining 20% ($48) plus the $90 balance between $240
and $330 – for a total of $138.
FInAl REQUEsT!!
Your medical coverage will terminate if you do not complete your on-line Participant Information Form by June 30, 2012.
ImPoRTAnT noTE ABoUT YoUR PhARmACY BEnEFITIn 2011, Express Scripts (ESI) announced plans to purchase Medco Health Solutions, our pharmacy benefit manager. ESI’s acquisition of Medco Health Solutions became effective in April 2012.
What does this change mean to you?• Your pharmacy benefits remain the same and
are now administered through ESI/Medco.
• You can continue to use the same Medco network pharmacy you currently use. The network of pharmacies under ESI/Medco remains the same at this time.
• All participants will receive new pharmacy ID cards sometime before the end of 2012.
Participant Serviceshealth–Welfare Benefits: Phone: 312-787-9455/Option 3 Fax: 312-951-1515 Pension Benefits: Phone: 312-787-9455/Option 4 Fax: 312-951-3986Contributions & Collections: Phone: 312-787-9455/Option 5 Fax: 312-787-3212Administration: Phone: 312-787-9455/Option 7 Fax: 312-951-2996Website: www.crccbenefits.org TRADES COUNCIL
ALLIED PRINTING
212CHICAGO, IL
® UNIONLABEL
June is national smile monthAccording to a poll taken by the American Dental Association,
a person’s smile outranked eyes, hair and body as the most important physical feature.
To celebrate National Smile Month, you are encouraged to:
• Brush at least twice a day with fluoride toothpaste • Floss every day • Reduce your intake of sugary foods and drinks
• Visit your dentist regularly every six months
overall health is Connected to oral healthManaging your oral health is critical. A healthy lifestyle that includes eating well and exercising, along with obtaining preventive dental care is the best way to maintain your body, including your gums and teeth. Sometimes, your dental health is affected by an underlying medical condition. Your dentist can assist in identifying a chronic health condition. For example:• One of the side effects of high glucose levels is problems
with your teeth or gums. Diabetics are also more susceptible to sore or loose teeth, fungal mouth infections, mouth ulcers, cavities and dry mouth. Those diagnosed with Diabetes may be eligible for the Enhanced Dental Benefits Program. Visit the Delta Dental website for more information.
• According to the American Academy of Periodontology, gum disease is linked to heart disease and stroke.
Did You Know?
Did You Know…75% of all oral cancers are associated with tobacco and alcohol use?
Did You Know…Overaggressive brushing can create exposed roots – exposed roots increase the risk of cavities.
Don’t Double Your Effort…a rotating electric toothbrush removes more plaque than a manual toothbrush.
Did You Know…You don’t need to “brush” with an electric toothbrush – just glide the brush gently over your teeth, and let it clean – no manual labor required!
online Resources for the Entire FamilyYou have multiple dental health tools available to you – free of charge – through Delta Dental.www.mouthmattersil.com is a fun and interactive website packed with information on helpful dental tips such as which summer fruits and vegetables promote oral hygiene. The website content is updated monthly, so keep checking back for more great information. You can also subscribe for email updates, to guarantee you stay informed!At www.oralhealth.deltadental.com, you will find a range of dental health resources for you and your family on pediatrics, adults, oral cancer, a risk assessment tool and large repository of articles by Harvard Health, including such helpful topics as “a basic brushing plan for clean teeth” and “are you getting enough vitamin D”.
