Effective January 1, 2022, the Local 282 Welfare Trust Fund, NY will offer an Empire MediBlue Freedom (PPO) Medical plan. Empire BlueCross BlueShield (Empire) Retiree Solutions will provide medical benefits for the Local 282 Welfare Trust Fund retirees through Empire’s Preferred Provider Organization (PPO) product, which includes the National Access Plus benefit. The PPO plan allows members to receive services from any provider, as long as the provider is eligible to receive payments from Medicare.

 

Local 282 Welfare Trust Fund members’ copay or coinsurance percentage will be the same whether their provider is in- or out-of-network. Locally or nationwide, doctors or hospitals, member share-of-cost (SOC) does not change.

 

Noncontracted providers may continue treating Local 282 Welfare Trust Fund members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member SOC.

 

The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers, while covering additional benefits that Medicare does not, such as LiveHealth Online* and SilverSneakers.*

 

The prefix on the Medicare Advantage ID cards is XLU.

 

Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool on the Availity* Portal at https://www.availity.com.

 

Providers will follow their normal claim filing procedures for Local 282 Welfare Trust Fund member claims.

 

Providers may call the number on the back of the member’s ID card for eligibility, prior authorization requirements and any questions about the Local 282 Welfare Trust Fund member benefits or coverage.

 

* Availity, LLC is an independent company providing administrative support services on behalf of Empire BlueCross BlueShield. Tivity Health, Inc. is an independent company providing the SilverSneakers fitness program on behalf of Empire BlueCross BlueShield. LiveHealth Online is the trade name of Health Management Corporation, an independent company, providing telehealth services on behalf of Empire BlueCross BlueShield.

 

EBSCRNU-0215-21 November 2021

 



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January 2022 Newsletter