Welfare Notes - October 2012

October, 2012

Unfit For Duty

The vision care benefit for active participants is allowed once in a two year period. The $200.00 maximum includes the exam and glasses. The cost of tints is not included in the reimbursable amount. The vision benefit is for members only and does not include dependents. An itemized bill must be submitted to the Plan office within 90 days of the service. The bill must indicate the patient's name, date of service, and an itemization of the charges.

The vision care allowance for pensioners is included in the $500.00 maximum of the Pensioners Annual Allowance for medical, dental, and vision co-payments. Glasses are an allowable expense once in a fiscal year.

Reimbursement for Active Participant Co-pays

Kaiser and other HMO Plan member's co-pays can be submitted to the Plan office by sending a copy of the copayment that indicates the patient name, date of service, and the amount charged the member. PPO Plan members must submit a billing and the PPO Plan explanation of benefits that show how the charge was applied to the plan and the required payment due from the member.

Unfit for Duty Documentation

It is important to make sure your attending physician submits Unfit for Duty documentation to the Plan office. The documentation may extend your medical and dental coverage and prevent a break in service that will affect your pension benefits. Be sure to have this information sent to the Plan office if you are injured on the job. Your employer will not automatically forward the information to the Plan office. It will be much easier to take care of this paper work during your Unfit For Duty period then try to reconstruct the information at a later date.

Michelle Chang, Administrator  
Patty Martin  
Virginia Briggs, Claims   
Michael Jacyna, Eligibility