Central States Benefits Now

[dogs.bite.me]

Hello Guys/Gals.

I am in a teamster controlled Central States Plan now. I just got full time in September of 2012 and so have only used it twice. Anyways this is directly off of their site, so I thought I would post this.

Treatments, services, or supplies not covered by your Plan include but are not limited to the following:

• Cosmetic care or treatment (except to the extent it’s required due to an accidental bodily injury).
• Any fees over the Reasonable and Customary limitation.
• Personal comfort items, state taxes, surcharges. Interest, late charges, completion of any claim form or missed appointments.
• X-rays, laboratory charges and professional fees incurred as part of a routine physical examination, except those charges covered under the TeamCare Wellness Benefit.
• Routine dental x-rays and laboratory work (see “Dental and Orthodontic Benefit”).
• Eye examinations for the correction of vision and fitting of glasses or contact lenses, except contact lenses or glasses for treatment of glaucoma, keratoconus or resulting from cataract surgery (see “Vision Benefit”).
• Injury or illness that is work-related or covered by Worker’s Compensation or an Occupational Disease Law.
• Charges for medical services that are not considered Standard Medical Care, Treatment, Services or Supplies.
• Hospital confinements that exceed the broadly accepted standards of medical practice.
• Maintenance Care.
• Charges for medical services and prescription drugs related to the treatment of infertility, including charges in connection with in-vitro fertilization, artificial insemination and reversal of prior sterilization.
• Treatment outside the United States shall be limited to treatment, services or supplies that are uniformly and professionally endorsed by the general medical community in the United States. Benefits will be paid In U.S. dollar amounts for similar treatment, care or services in the United States.
• Treatment or services for complications of medical, dental or vision procedures not covered by the Plan.
• Treatment or services received while in the Armed Services.
• Treatment or services that arise out of declared war or undeclared war or any act of civil disturbance.
• Treatment or services for injuries or illnesses sustained while participating in an illegal act which is in violation of a state or federal statute.

The Underlined one is a big one for me. WE have vision care that doesn't cover eye examinations?
Curious to see if the union increases the benefits we currently have on Central States.

 

[balland chain]

Hello Guys/Gals.

I am in a teamster controlled Central States Plan now. I just got full time in September of 2012 and so have only used it twice. Anyways this is directly off of their site, so I thought I would post this.

Treatments, services, or supplies not covered by your Plan include but are not limited to the following:

• Cosmetic care or treatment (except to the extent it’s required due to an accidental bodily injury).
• Any fees over the Reasonable and Customary limitation.
• Personal comfort items, state taxes, surcharges. Interest, late charges, completion of any claim form or missed appointments.
• X-rays, laboratory charges and professional fees incurred as part of a routine physical examination, except those charges covered under the TeamCare Wellness Benefit.
• Routine dental x-rays and laboratory work (see “Dental and Orthodontic Benefit”).
• Eye examinations for the correction of vision and fitting of glasses or contact lenses, except contact lenses or glasses for treatment of glaucoma, keratoconus or resulting from cataract surgery (see “Vision Benefit”).
• Injury or illness that is work-related or covered by Worker’s Compensation or an Occupational Disease Law.
• Charges for medical services that are not considered Standard Medical Care, Treatment, Services or Supplies.
• Hospital confinements that exceed the broadly accepted standards of medical practice.
• Maintenance Care.
• Charges for medical services and prescription drugs related to the treatment of infertility, including charges in connection with in-vitro fertilization, artificial insemination and reversal of prior sterilization.
• Treatment outside the United States shall be limited to treatment, services or supplies that are uniformly and professionally endorsed by the general medical community in the United States. Benefits will be paid In U.S. dollar amounts for similar treatment, care or services in the United States.
• Treatment or services for complications of medical, dental or vision procedures not covered by the Plan.
• Treatment or services received while in the Armed Services.
• Treatment or services that arise out of declared war or undeclared war or any act of civil disturbance.
• Treatment or services for injuries or illnesses sustained while participating in an illegal act which is in violation of a state or federal statute.

The Underlined one is a big one for me. WE have vision care that doesn't cover eye examinations?
Curious to see if the union increases the benefits we currently have on Central States.

Read the header....But are not limited too..OH there are pages...Bend over ya'all its coming....

 

[dogs.bite.me]

Participants and their eligible dependents may receive an eye examination and glasses or contact lenses every 12 months at participating TeamCare Vision providers. Your co-pay is $10 for all Plans, except Plans A and B which are $15. Your co-pay allows you the following: a spectacle exam plus lenses (either single vision, bifocal, trifocal, or lenticular) and frames up to a value of $100 (or contacts up to a value of $80). Contact lens exams are extra. You may contactEyeMed Vision Care at 1-800-334-7591 for further information on benefits and providers.

But this is in the vision part of the coverage... Im a bit confused.

 

[TooTechie]

That's likely because this is the medical portion of the coverage. I assume the dental & vision are handled by other vendors. For example some have Aetna or Blue Cross for medical, then Davis for vision, and I think Guardian for dental.

 

[dogs.bite.me]

This is on the central States site, not the Blue Cross one, and it is Humana for Dental, and EyeMed for vision

 

[sortaisle]

Again...the odds of EVERYONE moving to the central states plan is low. There are coverage companies on central states that don't exist on the East or West coast (never heard of Davis...we have VSP.) You will most likely be moved to your local unions insurance.

 

[brownmonster]

That's likely because this is the medical portion of the coverage. I assume the dental & vision are handled by other vendors. For example some have Aetna or Blue Cross for medical, then Davis for vision, and I think Guardian for dental.

Its all in the details.

 

[upswife75]

Yes, vision is covered, through EyeMed Vision Care.

EyeMed Benefit is as such:

Contact Lenses, Exam, Frame, Lens: Once within 12 months defined by benefit period.

Exam: $10 copay
Dilation: $0
Eye Exam Refraction: $0
Single Vision Lens: $0
Bi-Focal: $0
Tri-Focal: $0
Standard Progressive Lens: $60 Copay
Premium Progressive Lens: $60 Copay + (80% of Charge) less $105 allowance
Lenticular: $0
Other Lens Type: 70% of Charge
Frame: 80% of Balance over $100

Contacts: 85% of Balance over $80 for conventional and Balance over $80 for disposable
LASIK: 85% of Charge

 

[brett636]

I currently hold three insurance cards. Aetna for doctor and dental visits, medco for prescriptions, and Blue cross/blue shield for Hospital stays. I am curious to see how or if this will change given the changes in who our insurance is run through.

 

[sortaisle]

Health Benefits: Many members are asking about the deal to move all full-time and part-time Teamsters out of company-provided health insurance and into the Central States Health and Welfare Plan and other Teamster plans. The benefits currently provided by the Central States Plan,available here, will reportedly be enhanced to make them equal with members’ current benefits.

This is from the dreaded TDU. Note it says Central States and OTHER TEAMSTER PLANS. Central States is prominently discussed because it covers a wide range of states. You will more than likely be put into YOUR LOCAL UNION PLAN. States like mine (Washington) won't allow outside providers to cross state lines for insurance. I'm sure they're other states that do likewise.

 

[sortaisle]

If I'm wrong, I'll happily and humbly apologize and join Stink and 407 in TDU bashing.

 

[ReLooped]

I currently hold three insurance cards. Aetna for doctor and dental visits, medco for prescriptions, and Blue cross/blue shield for Hospital stays. I am curious to see how or if this will change given the changes in who our insurance is run through.

i have the same setup...makes finding therapists and doctors for my son easier. and im curious as well.

 

[Bagels]

Again...the odds of EVERYONE moving to the central states plan is low. There are coverage companies on central states that don't exist on the East or West coast (never heard of Davis...we have VSP.) You will most likely be moved to your local unions insurance.

It's plausible for all employees to be merged into a single, unified plan and then have that administrator contract different managing partners -- this is how the PTers insurance is provided today.

If the Teamsters choose CS as the surviving, unified plan, it would have nothing to do with geography.

 

[barnyard]

It would appear that the OP either did not find the Vision and Dental coverage on the website or reading comprehension is horrible. I am in Central States and am very pleased with the dental and eyecare coverage that we have.

 

[upswife75]

I currently hold three insurance cards. Aetna for doctor and dental visits, medco for prescriptions, and Blue cross/blue shield for Hospital stays. I am curious to see how or if this will change given the changes in who our insurance is run through.

At the beginning of the year, we got new cards. One was the main medical Card that shows Central States at the top then the rest looks like a standard BC/BS card. The other card has all the other individual plan provider stuff, like EyeMed, MayoClinic, Humana Dental, US Imaging, CVS Caremark, and Quest (for labwork); along with each of their contact numbers and such. It made things so much easier.

 

[IVE GOTTA PACKAGE 4U]

If I'm wrong, I'll happily and humbly apologize and join Stink and 407 in TDU bashing.

Do you know? that the TDU SUCKS?...just ask Stink!

 

[dogs.bite.me]

It would appear that the OP either did not find the Vision and Dental coverage on the website or reading comprehension is horrible. I am in Central States and am very pleased with the dental and eyecare coverage that we have.

Neither. I posted the vision coverage in a different post. I was just confused. It has ask your coverages listed, then beneath that it says what we don't cover. And the vision party just struck me.

The insurance hasn't been bad. $16 on my daughters last visit.