Benefit Updates

New MEDICARE Requirement for Medicare Prescriptions

CMS (Centers for Medicare and Medicaid Services) implemented a new policy effective January 1, 2014 which requires pharmacies, both retail and mail order, to obtain approval from the member/participant to deliver a prescription, new or refill, prior to each delivery.  This is a Medicare requirement and only pertains to Medicare prescriptions.

**UPDATED**FLEXIBLE SPENDING ACCOUNT/WALGREEN ISSUE

*****UPDATED***** January 13, 2014

If any member had to pay cash to Walgreens during the timeframe of January 8, 2014 to January 13, 2014 due to an issue where their (Walgreens) systems were not accepting the Flexible Spending Accounts, please fax the receipt and claim form to the Verizon Benefits Center.  Claim form and fax number can be found on the benefits center website at www.verion.com/benefitsconnection.

OLD POST:

The Verizon Benefit Center (VBC) has been notified of an issue with Walgreens and member’s ability to utilize their Flexible Spending Account (FSA) cards at this retailer. Walgreens states that this problem began today, 1/10/14, and they are working to correct the problem. This issue will result in eligible claims being denied under the FSA card. You may want to use another pharmacy until this is corrected. If you have a claim that you feel should have been accepted, you should retain your receipts for any claims paid out of pocket. We will post an update to this web as soon as the issue is resolved and what the process will be for processing any claims affected by the Walgreen FSA issue.

Important info for Members taking an EISP

Medicare ID Cards

Members who become Medicare eligible at age 65 will not receive their new ID cards from the medical plan prior to mid-month of the month they turn 65, at the earliest. This is because VBC (Xerox) does not notify the health plan of your status change until after you turn 65. VBC is working on updating this for 2014, but at this time this is the process. Until you get a new card, continue to use your old card. If you have an office visit, the provider’s office can call VBC to verify that your co-pay has changed to $10.

Workmans Comp/Medical Restriction info

The following is information for any member who may have a restriction or need an accommodation for their job. This includes information as this practice may relate to Workers Compensation.

MR/LOA, WC, ADA

•             If a member is on Workers Compensation, may the Company place the member off payroll after 150 days?

Yes. The member would incorporate lost wages as part of their compensation claim, track their time and keep their Worker’s Comp attorney advised

•             Is it proper for a member to apply for Unemployment benefits when placed on a MR/LOA?

Yes. However if a member applies for SSDI, that may negatively impact their case

•             When a member is notified they are being placed into the MR/LOA plan, what steps should the member take?

The member should contact WFI (877-635-1231). The member’s doctor should follow the process to assist the member in their request for an accommodation (submit clinical information to support the accommodation). No medical information should be given to the supervisor.  Member may choose to self-identify under the Americans with Disabilities Act (ADA) if they are ADA qualified. If no relief, member should consider an outside attorney who specializes in disability law. Some units have an attorney they are familiar with that have represented our members well, so members may inquire at the unit office for a referral, otherwise there is Union Plus Legal Services 888-993-8886. (handout provided) www.unionplus.org/legal-aid-services  

•             For answers to additional questions, call the ADA Information Line-800-514-0301  www.ada.gov/qandaeng.htm

ARC Phone Number

Reminder: the number for ARC for FMLA issues is 1-855-814-9344

A message from our Health Care Benefits Coordinator Paula Small:

 
This is the list of the “exempt infant formula” as defined in the FDA regs that MAY be covered under our Rx plan if medically necessary and approved (from the OTC addendum agreement to the MOU).
 
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/InfantFormula/ucm106456.htm)
Paula M. Small 
Health Care Benefits Coordinator 
Local 1944 IBEW
E-mail: paula.m.small@verizon.com

Out-of-Network Anthem Claims

 
The Union has received calls from our members in regard to checks that are mailed directly to them from Anthem, our medical carrier. Verizon has informed us of the following:
 
Anthem’s standard process is to pay out-of-network provider claims directly to the participant.  This is one of the administrative differences that was discussed during bargaining.  In the event the participant would like Anthem to pay the provider directly, the member will need to make this request of an Anthem representative PRIOR to the submission of a claim. The members record would then be flagged.
 
 
Karen Lane
Vice-President

Aetna Cards

We have been getting some members inquiring as to why they have recently received Aetna insurance cards in the mail. Please read the back of the card, it may be for your dental coverage, which is still Aetna.

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