Annual Notice 2003
To All Employees and Dependents:
This Notice is to inform you of the following:
- Increase in your routine physical examination benefit
- Changes to Accident and Sickness Weekly Benefits payable for disability due to nervous and mental disorders, alcoholism, and substance abuse
- Women's Health and Cancer Rights Act Annual Notification
Routine Physical Examination Increase
(Employees and Spouses in All Classes)
Routine physical examinations performed through the Health Dynamics Preferred Provider Preventive Care Program are covered in full, up to the maximum amount approved by the Trustees. Trustees recently approved a fee increase for the Health Dynamics Program from $465 to $478. To align with the amount payable for the Health Dynamics Program, we are pleased to announce that the benefit for routine physical examinations under Comprehensive Major Medical Benefits for the employee and spouse will increase from $465 to $478 per person per calendar year effective January 1, 2004.
Accident and Sickness Weekly Benefits Changes
(Active Employees Only)
Effective January 1, 2004, Accident and Sickness Weekly Benefits will be limited if you are totally disabled due to nervous and mental disorders, alcoholism, and substance abuse to align with those benefits payable under Comprehensive Major Medical Benefits. Accident and Sickness Weekly Benefits will be limited to the following:
- 10 days per person per calendar year for treatment of nervous and mental disorders while hospital confined
- 30 days per each person's lifetime for treatment of alcoholism and substance abuse while hospital confined.
- AND -
No Accident and Sickness Weekly Benefits will be payable if you are being treated for nervous and mental disorders, alcoholism, or substance abuse on an outpatient basis.
Women's Health and Cancer Rights Act Annual Notification
The Women's Health and Cancer Rights Act of 1998 requires that we notify you annually of the coverage required under this Act. This Notice fulfills that requirement.
The Women's Health and Cancer Rights Act of 1998 amended ERISA by requiring group health plans which provide medical and surgical benefits for a mastectomy to provide the following coverage if you elect breast reconstruction in connection with a mastectomy, in a manner determined in consultation with the attending physician and the patient:
- reconstruction of the breast on which the mastectomy has been performed
- surgery and reconstruction of the contralateral breast to produce symmetrical appearance
- coverage for prostheses and physical complications of all stages of mastectomy, including lymphedemas
- AND -
Subject to any applicable deductible and co-payment requirements, your Plan provides coverage for the preceding items. Such surgical benefits are payable on the same basis as any other surgical procedure covered by the Plan.
Please keep this Notice in your Summary Plan Description for future reference. If you have any questions about this information, feel free to contact the Fund Office.
Yours very truly,
THE BOARD OF TRUSTEES
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