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FOR PARTICIPANTS WITH THE MEDICAL/DENTAL CENTER PLAN

The Affordable Care Act prohibits health plans from applying arbitrary dollar limits for coverage for key benefits. This year, if a plan applies a dollar limit on the coverage it provides for key benefits in a year, that limit must be at least $2 Million.

Your health insurance coverage, offered by the NOITU Insurance Trust Fund, does not meet the minimum standards required by the Affordable Care Act described above. Instead, it put an annual limit of:

Referrals

Benefits

Specialist /Diagnostic

(1) specialist and (1) diagnostic test referral per Calendar Year. $150 Maximum toward the cost of a single specialist Consultation or diagnostic test referral per Calendar Year.

                                                                                 

Please be aware that not all of the following drug plans may pertain to you. It is important for you to refer to your enrollment documents (e.g. Summary Plan Description) for more information on your specific drug plan or you may contact the NOITU Insurance Trust Fund's Member Services Department at 718-291-3434, option 3.

 

Prescription Drugs

Benefits

$10/$30 copay plan

$3,000/$6,000 annual maximum

$7.50/$20 copay plan

$1,500/$3,000 annual maximum

Rx MCDC $350

$350 maximum per year

 

In order to apply the lower limits described above, your health plan requested a waiver of the requirement that coverage for key benefits be at least $2 million this year. That waiver was granted by the U.S. Department of Health and Human Services based on your health plan's representation that providing $2 million in coverage for key benefits this year would result in a significant increase in your premiums or a significant decrease in your access to benefits. This waiver is valid for one year.

If the lower limits are a concern, there may be other options for health care coverage available to you and your family members. For more information, go to: www.HealthCare.gov.

If you have any questions or concerns about this notice, contact:

Candice Stark, Administrator

NOITU Insurance Trust Fund, 148-06 Hillside Avenue, Jamaica NY 11435

 

 

 

SI USTED NO HABLA INGLES, Si tiene dificultad de entender cualquier parte de este documento, Ilame a la oficina de 9:00a.m. a 5:00p.m., de lunes a viernes, (718) 291-3434, seleccione el numero #3, para ayudarle.

 



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