Local 3 recognizes the importance of providing our members and their families with comprehensive medical insurance plans. Each year when evaluating plan designs and costs, consideration is given to what changes are necessary in order to maintain comprehensive benefits while controlling costs for our members.

We are pleased to announce that for the 2012 plan year we will be offering NEW SimplyBlue Excellus BlueCross BlueShield plans.

2012 Medical Plan Highlights

Please refer to the Excellus side by side comparison for a detailed list of benefits.

Monthly Premium Effective 1/1/2012-12/31/2012 

The benefits you receive for most medically necessary covered expenses are determined as follows:

• For office visits to your primary care physician and specialist, as well as prescription drugs you pay a copayment and then the plan plays 100% of the charges.

• For other services, you must satisfy the annual deductible before the plan begins to pay benefits.  Once the deductible is met, coinsurance applies.  The plan has a $250 per individual deductible; and $750 for an entire family.

• Deductibles do not include copayments.  This means that the deductible does not need to be met before services with co-pays are covered.

• The plans co-insurance is 80%/20%, meaning that for services that have co-insurance applicability, the plan pays 80% of the charge and the participant pays 20% of the charge after the deductible is met. 

• If you reach the annual out of pocket maximum, co-insurance no longer applies and the plan will pay 100% of covered medical expenses for the balance of the plan year.  The annual out of pocket maximum for an individual is $750; $2,250 on an aggregate level for a family. 

• Out of pocket maximums include deductibles but do not include co-pays and expenses in excess of allowable charge.

2012 Dental Plan 

Local 3 is pleased to continue to offer members an opportunity to purchase a comprehensive dental benefit plan (High Plan) as well as a new lower costing dental plan (Core Plan).  The members monthly costs are outlined below.

*UCR is the usual, customary, and reasonable charge for the service in the area in which it was provided.  Payment is based on the lesser of billed or UCR charges. 

What do you need to do during the OPEN ENROLLMENT period?

  To make changes or to enroll in any of the following benefits for 2012 you must complete the following forms:

• Medical Plan:  Excellus Enrollment Form
• Dental Plan: HEG Enrollment Form  

*Please note that if you were enrolled in the 2011 medical plans and did not change plans you were automatically mapped to the following on January 1, 2012:

• Healthy Choices A      Buy-Up SimplyBlue $15/$25 Copay Plan

• Healthy Choices B      Core Plan SimplyBlue $30/$50 Hybrid Plan

You will only need to complete an Excellus enrollment form if you would like to change plans, add or cancel a dependent.

Contact your Local Chapter Fund office to obtain enrollment forms and information.

NOTE:  After the Open Enrollment Period, you cannot make changes to your coverage during the year unless you experience a change in family status, such as: 

•         Loss or gain of coverage through your spouse
•         Loss of eligibility of a covered dependent
•    Death of your covered spouse or child
•        Birth or adoption of a child
•        Marriage, divorce, or legal separation
•    Switch from part-time to full-time 

You have 30 days from a change in family status to make changes to your current coverage.