Teamsters Joint Council No. 83 of Virginia
Health & Welfare and Pension Funds
Health Insurance Portability and Accountability Act (HIPAA)
As part of our operations, we create and receive certain information about our participants relating to your physical or mental health, the provision of health care to you, and the past, present or future payments for the provision of health care to you. The privacy practices described herein refer to "protected health information". Protected health information is information that is identifiable to an individual.
Disclosure of Grandfathered Status (grandfathered status applies to all accounts other than National Fruit Product Company, Inc.)
This group health plan believes it 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 plan administrator, Michael McCall, CEBS at (804)282-3131 or toll free at 800-852-0806. 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.
Newborn and Mothers' Health Protection Act
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
Women's Health and Cancer Rights Act
The Women's Health and Cancer Rights Act of October 21, 1998 protects individuals who elect breast reconstruction in connection with a mastectomy. If you or your eligible dependent received benefits under this Plan in connection with a mastectomy and then elect breast reconstruction, coverage will be provided for the following:
- Reconstruction of the breast on which the mastectomy was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance;
- Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas.
Payment for breast reconstruction follows the same guidelines established for all surgical procedures performed under the Plan. All deductibles and maximums contained in your schedule of benefits for surgical procedures and the related charges also apply to breast reconstruction surgery and the related charges.
Uniformed Services Employment and Reemployment Rights Act
If you, as a Participant of the Pension Plan, leave Covered Employment to serve in the military, you will continue to earn Benefit Accrual Service up to a maximum of five years as if you had continued to work in Covered Employment. Under The Uniformed Services Employment and Reemployment Rights Act (USERRA) of 1994, your employer must pay your pension contributions if you return from active duty and apply for reemployment within 90 days. In the event you are reemployed by a different Covered Employer, then each employer is liable to the Pension Fund for half of the required contributions.