Reinstatement of Body Scan Benefit to 100% of Cost

SOUTHERN CALIFORNIA IBEW-NECA HEALTH TRUST FUND
Important Notice to Participants
July 2012

Dear Participant:

Reinstatement of Body Scan Benefit at 100% of Cost. The Trustees are pleased to announce that effective August 1, 2012, the 50% co-payment for body scans is no longer applicable.¹ The Plan will cover 100% of the cost for 20 appointments per calendar month. This benefit is not subject to the satisfaction of the annual deductible. The body scans are limited to one per eligible individual per calendar year. As a reminder, the Body Scan benefit is allowed for all Participants and Spouses or registered Domestic Partners, only.

All services must be rendered by Body Scan International at their Tustin location. Claims from other providers will not be paid.

Continued Grandfather Status. The Board of Trustees of this group health Plan believes this Plan is a "grandfathered health plan" under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your Plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the Board of Trustees, c/o The Southern California IBEW-NECA Administrative Corporation at either (323) 221-5861 or toll-free at 1-(800)824-6935. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.

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1. The Trustees elected to implement a 50% co-payment for the Body Scan benefit effective February 1, 2012 ($447.50) in order to reduce the projected operating deficit for the following fiscal year period.  

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