Effect on Plan Benefits
If you have other health care coverage, the benefits payable under the Trust Early Retiree Preferred Provider and Indemnity Medical Plans, and the Trust Early Retiree Voluntary Dental/Vision Plan may be reduced.
The Trust Early Retiree Medical Plans
If you have other health care coverage, the benefits payable under the Trust Early Retiree Plan 1 (Closed) and the Trust Early Retiree Plan 2 (Open) may be reduced, as follows:
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If the other plan providing health care coverage does not have a coordination of benefit provision: The Trust Early Retiree Medical Plans (Plan 1 and Plan 2) will reduce the amount they pay so that the amount paid under both plans does not exceed 100% of covered expenses. The benefits payable under each plan will be reduced proportionally to assure that benefits do not exceed the amount of the covered expenses.
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If the other plan providing health care coverage has a coordination of benefits provision: The coordination of benefits provision will be followed to determine which plan pays secondary. If the Trust Early Retiree Medical Plans (Plan 1 and Plan 2) pay secondary, they will not pay more than the amount of benefits they would have paid for the covered service or supply had they been the primary plan. The Trust, however, will keep a record of the difference between what was paid and what would have been paid if the Trust Early Retiree Medical Plans (Plan 1 and Plan 2) were the primary payer. These savings will be applied to other covered expenses you incur during the same calendar year. These savings cannot be used for expenses other than covered expenses under the Trust Early Retiree Medical Plans (Plan 1 and Plan 2) and cannot be carried forward beyond the calendar year in which the savings were recognized.
The Trust Early Retiree Voluntary Dental/Vision Plan
If you have other health care coverage, the benefits payable under the Trust Early Retiree Voluntary Dental/Vision Plan may be reduced, as follows:
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If the other plan providing dental/and or vision coverage does not have a coordination of benefit provision: The Trust Early Retiree Voluntary Dental/Vision Plan will reduce the amount it pays so that the amount paid under both plans does not exceed 100% of covered expenses. The benefits payable under each plan will be reduced proportionally to assure that benefits do not exceed the amount of the covered expenses.
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If the other plan providing dental and/or vision coverage has a coordination of benefits provision: The coordination of benefits provision will be followed to determine which plan pays secondary. If the Trust Early Retiree Voluntary Dental/Vision Plan pays secondary, it will not pay more than 100% of the allowed amount for the covered service. The Trust, however, will keep a record of the difference between what was paid and what would have been paid if the Trust Early Retiree Voluntary Dental/Vision Plan were the primary payer. These savings will be applied to other covered expenses you incur during the same calendar year. These savings cannot be used for expenses other than covered expenses under the Trust Early Retiree Voluntary Dental/Vision Plan and cannot be carried forward beyond the calendar year in which the savings were recognized.
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