Date :              January 3, 2005 

To :                 I.B.T. Local No. 145 Health Services & Insurance Plan Membership 

From :             Board of Trustees

 Re:                  Anthem Blue Cross Blue Shield of Connecticut (ABCBSCT)

Medical Plan Claims Administration

Effective January 1, 2005

 Happy New Year !!!   We hope that the New Year brings health and happiness to all of our members and their families.

 Enclosed is a Welcome Kit from Anthem Blue Cross Blue Shield of Connecticut (ABCBSCT).   As previously communicated to the membership, the Fund is no longer processing medical claims directly.   As of January 1, 2005, our network partner, ABCBSCT, is processing medical claims on behalf of the Fund.    

 In order to maximize the benefits of this change, please remember :

 ·         You should have a new Blue Cross Blue Shield ID card.   This new card will have a new ID number.  It is important for you to share this information with your doctors.

 ·         If you have questions regarding the medical program, ABCBSCT has a dedicated Taft-Hartley member service number that is available 8 AM – 5 PM EST.   Please call 800-922-6621 if you have questions regarding your medical plan coverage, pre-certification requirements, network providers, ID cards and/or claims status.    Note that the Fund Office personnel are still available for more complex matters and/or questions on other benefits provided through the Fund.

 ·         The calendar year deductible of $500 individual / $1,000 family starts with medical claims other than office visits incurred after January 1, 2005.   The deductible applies to all claims other than office visits or simple diagnostic x-ray and laboratory charges.  This means that the initial claims submitted to ABCBSCT will be processed, but will be applied to meeting your deductible. Members are responsible for paying providers directly until the eligible charges submitted to ABCBSCT total the deductible amount for the year.  Once the deductible is met, coverage commences.  Please refer to the enclosed Benefit Description for an overview.  Complete member handbooks with detailed descriptions of the medical benefits provided will be sent under separate cover.

 ·         The listing of services needing Prior Authorization has changed slightly.   If you or a family member is scheduled for (or has emergency) hospitalization, surgery or advanced radiology, make sure that you call ABCBSCT to obtain approval.  Failure to do so will result in penalty.  

 ·         ABCBSCT has a variety of health and wellness services available to the membership.  We encourage you to use the website at www.anthem.com for information relating to discounts on health related products and to obtain access to the Health Information library. 

Remember, the change in medical plan claims administration does not affect the processing or payment of any other benefits provided to you and your family through the Fund, such as prescription drugs, dental and vision benefits.