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Plan Updates
Additional Change omitted from November 1, 2006 SPD
Charges incurred outside the United States, including the territories of the United States are covered if (a) the services would have been a covered expense if provided in the United States; (b) the Covered Person is not covered by any other country's national health care; and (c) the person has not been outside the United States for a period exceeding one year. Benefits for non-emergency care provided outside the United States under this benefit are limited to $200,000 per calendar year. Emergency care is covered the same as if the care were rendered in the United States, however, once a Covered Person receiving emergency care is stabilized so that the person could be transported to the United States, this limitation applies to any further charges
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USERRA Regulations |
| 25. |
Effective January 1, 2013, the Plan has arranged to utilize the Independent Review Organizations with agreements with Cigna for all external Appeals. |
| 24. |
Effective May 1, 2012 – Changes to Coverage of Out of Network Prescription Drug Benefit |
| 23. |
Effective January 1, 2012 - Changes to Medicare Retiree Plan of Benefits |
| 22. |
Effective July 1, 2011 Changes – Coverage of Children to Age 26, Life Time and Annual Maximums, Pre-Existing Condition Exclusion, Mental Health and Substance Use Disorder Benefits and Covered Charges |
| 21. |
Section 14.3 Dental Covered Services and Benefits is hereby amended to provide that coverage A full-mouth diagnostic x-rays will be covered more than once every five years if medically necessary |
| 20. |
Effective November 1, 2006 Coordination of Benefits with Medicare Parts A and B |
| 19. |
Allow pre-Medicare retirees to elect COBRA upon retirement and at the end of COBRA coverage to enroll in the Fund’s pre-Medicare retiree Value Plan until reaching Medicare eligibility |
| 18. |
Effective April 1, 2009 - Michelle's Law, Public Law No: 110-381, provides continued coverage for Qualified Dependents who are between the ages of 19 and 25 and who would otherwise lose coverage because their status as full-time students ended as a result of a severe illness or injury. |
| 17. |
Effective April 1, 2009 - Special enrollment period for any Dependent who becomes eligible for coverage due to the loss of coverage under a State Children's Health Insurance Program (SCHIP |
| 16. |
Effective January 1, 2009 - Elimination of Genetic Information. |
| 15. |
Effective January 1, 2009 - Retiree eligibility coverage for participants in the the PISTL 502P Welfare Plan. |
| 14. |
Effective November 1, 2008 - Provision whereby the Fund will reimburse Medicare part B premium of any active participant for whom Medicare is primary |
| 13. |
Effective April 1, 2008 - Changes in Step Therapy Program |
| 12. |
Effective January 1, 2008 - Clarification of Dental Language |
| 11. |
Effective March 1, 2008 - Revised Retiree Eligibility Rules |
| 10. |
Effective November 1, 2006 - Value Plan Life Time Maximum |
| 9. |
Effective January 1, 2008 - Open Access Prescription Drug Benefits |
| 8. |
Effective January 1, 2008 - Coordination of Open Access Medical Benefits & Out-of-Pocket Annual Maximum |
| 7. |
Effective January 1, 2008 - Coordination of Dental Benefits |
| 6. |
Effective January 1, 2008 - Semi-Annual Open Enrollment Period |
| 5. |
Effective January 1, 2008 - Wellness Program Changes |
| 4. |
Effective January 1, 2008 - Change in Rx OOP Maximum for OA Medicare Retirees |
| 3. |
Effective June 1, 2007 - Orthopedic Shoes and Orthotics |
| 2. |
Effective May 1, 2007 - Specialty Pharmacy Changes |
| 1. |
Effective December 1, 2006 - Human Papilloma Virus vaccinations |
