HB Bulletin #40-14

HB Bulletin #40-14

December 4, 2014

HEALTH BENEFITS BULLETIN

WELFARE & PENSION CLAIMS

Brothers and Sisters,

Welfare Claim - If you are not able to work the required hours in 2014 (800 hours for Welfare or a basic Pension) due to being under a doctor’s care and unable to work on (TTD) Temporary Total Disability, you must file a Welfare claim.  

The plan administrators at ILWU/PMA Benefit Plans will review the total hours for 2014 and will notify you via mail during the first quarter of 2015.

Your Welfare coverage is from July 1, 2014 through June 30, 2015, so relax, you have a little time to file your Welfare Claim.  

Pension Claim – If you suffered a non-industrial illness or injury, up to a maximum of 200 hours claim may be filed to make any pension adjustment.

Industrial or Workers’ Compensation – An LS-208 and doctor’s note is required for Pension Claim.

Important: the above claims require a Dr.’s note, it must state “under a doctor’s care and unable to work”.  Dates should be from beginning to end. Note must be on letter head, currently dated and signed by the doctor.

Claims are not automatically filed, it is YOUR responsibility to file and submit all your documents to ILWU Local 13 Health Benefits Department.

DOCTOR NOTES

Protect yourself from any employer complaints, 8.34 non availability or 70% by submitting doctor notes to PMA.  (Class A and Class B must have notes stamped by PMA before submitting to the local).  This does not guarantee the employer will not file a complaint against you.  However, will help you justify your absence.  Keep your original stamped notes in a safe place.

COASTWISE ZENITH UPDATE

ILWU Local 13 has successfully secured an extension of stay for the Coastwise Zenith Representative; David Bisuano.  David will be available at Local 13 and will continue to assist you with any problematic claim(s), please take advantage of this service.  

This service is available for Members and their family only, NO PROVIDERS.  

David Bisuano may be reached at (310) 830-6116 ext. 122, Monday through Friday, 8:30 a.m. to 4:10 p.m. or if you’d like to come into ILWU Local 13 – 630 South Centre Street, San Pedro, CA 90731 please sign in at Receptionist’s desk and patiently wait to be seen.  While you wait make sure to have your claims/bills ready and out of the envelope.

We will continue advocating until everything stabilizes. The fight is far from being over.  

(Over)

UTILIZING IN-NETWORK PPO BLUE SHIELD

Claims from “in network” providers have the least difficulty getting processed and paid, DO NOT assume that your “in network” provider will refer you to “in network” providers for other services.  If they refer you for anything outside their office; such as blood work, diagnostic testing (MRI’s, CT Scans, X-rays, etc.), to see a specialist, or for other treatment such as; surgery, physical therapy etc. your very first question to them should be: “Is that provider in network?”  If they are not, you may request a referral that is “in network” or use that provider knowing that it will be paid at the 80/20 of Maximum Allowable Charges (MAC) rate.  

MEMBERSHIP MEETINGS

Attend your membership meetings, read your UNION Bulletins. DO NOT LISTEN TO RUMORS! Hear it first hand from your Officers and Caucus Delegates! We must support our Negotiating Committee and our Caucus Delegates.

SAFETY TIP

Scope, Purpose and Exceptions Section 1 – Rule 102. The purpose of this Code is to provide minimum requirements for safety of life, limb and health.  In cases of practical difficulty or unnecessary hardship an employer or ship may make exceptions from the literal requirements of this Code and permit the use of other devises or methods, but only when it is clearly evident that equivalent protection is provided.  

LOCAL 13 OFFICE CLOSING FOR THE HOLIDAYS

The office of ILWU Local 13 will close during the Christmas and New Year Holidays starting on Wednesday, December 24, 2014 through Friday, January 2, 2014 and will re-open on Monday, January 5, 2015.  

RETIREMENT WORKSHOP

In the past, ILWU Local 13 has presented various types of workshops to better inform and service the membership.  The next scheduled Retirement Workshop will take place during the first quarter of 2015.  Over 450 people attended the 2012 Retirement Workshop.  We anticipate double the attendance in 2015.

APPOINTMENT WITH THE HEALTH BENEFITS OFFICER

The Health Benefits Officer maintains an open door policy, however, if you need special assistance, (i.e. retirement, disability or personal matter) we recommend that you schedule an appointment with Jerry Avila at (310) 830-6116.

LONG LIVE THE ILWU!