A message from the Trustees to Participants, Dependents, and Beneficiaries of the NECA-IBEW Welfare Trust Fund and the NECA-IBEW Pension Trust Fund in response to the Coronavirus (COVID-19) crisis:
March 13, 2020; updated March 23, 2020; updated April 1, 2020; updated May 12, 2020; updated December 23, 2020; updated May 12, 2023
Welfare Fund Coverage and Eligibility
Regarding testing for COVID-19, for dates of service before May 12, 2023, the Fund covers such testing and testing-related expenses (including office, urgent care, emergency room, and telehealth visits related to testing) at 100% with no cost-sharing. Such testing coverage includes testing both diagnostic and antibody/antigen types of testing. Effective May 12, 2023, the Fund will cover such testing and testing-related expenses subject to standard Plan rules (deductible, office copays, coinsurance, etc.).
Regarding treatment for COVID-19, the Fund covers any and all FDA-approved/authorized, medically necessary, “standard of care” treatment (physician, hospital, emergency), supplies, and/or drugs prescribed for this condition as we would be with any other sickness, subject to standard Plan rules (deductible, office copays, coinsurance, etc.).
Regarding vaccinations for COVID-19, the Fund covers COVID-19 vaccinations and related administrative services at 100% with no cost-sharing under both the Comprehensive Major Medical Benefit and Prescription Drug Benefit. COVID-19 vaccine coverage is subject to all other Plan provisions. All covered Persons who are medically able are strongly encouraged to obtain the COVID-19 vaccine through a network pharmacy, when available. This will reduce cost exposure to the Fund.
Regarding the weekly income (short term disability) benefit as it relates to Participants who may be ill or quarantined because of COVID-19 – the Fund would rely on the Plan provisions to decide on any claim for weekly income (short term disability) benefits. Each case and claim would be reviewed based on its own facts and circumstances.
Regarding eligibility, the Welfare Fund’s current eligibility provisions remain in place. This generally means that eligibility will end if any Participant exhausts his/her hour bank and does not elect COBRA. There are certain exceptions which may result in eligibility “freezes." Please refer to your SPD, the Fund’s Plan Document, or contact customer service for specific questions on eligibility.
Welfare Fund Telehealth and Virtual Visits Coverage
For dates of service before May 12, 2023, the Fund covers telehealth visits related to COVID-19 testing at 100% with no member cost sharing. For dates of service on or after May 12, 2023, telehealth visits related to COVID-19 tests will be subject to standard Plan rules (deductible, office copays, coinsurance, etc.).
The Fund has a Virtual Visits benefit with MDLIVE. Services provided through MDLIVE are covered at 100% with no cost-sharing. If you need more information on the MDLIVE benefit, please visit https://www.neca-ibew.org/Documents-and-Forms then select “Welfare Summary Material Modifications” then select the “MDLIVE” document, or contact customer service. NOTE: MDLIVE has a mandatory guided process of action for patients who present to a virtual visit with specific criteria for having contracted the coronavirus, which includes an ER referral and notification to the patient’s local health department.
CVS/Caremark has indicated that there are no disruptions to supply chains related to their ability to fill retail or mail-order prescriptions. CVS has also instituted home delivery to their pharmacy customers and early-refill waivers for maintenance medications. Please see the attached document for more information.
Investments and Finances
The Trustees of both Funds, along with the Funds’ professional service providers, continue to evaluate investments, Fund assets, and the economy in general through this pandemic stage. Hourly contributions across the Funds continue to be strong. We are committed to the long-term stability of the Funds and their ability to provide consistent benefits into the future. Accordingly, any and all decisions related to the finances of the Funds will be made with those principles in mind.
Fund Office Operations
The Fund Office is open to walk-in visits.
Although there could be some minor delays in service due to call volume, the Fund Office staff is prepared with information to answer questions from Participants, Dependents, and providers regarding coverage of COVID-19-related services and supplies, as well as those usual plan-related questions. Persons with questions on any topic are encouraged to contact customer service at 1-800-765-4239, option #6. Customer service is being maintained from 7:00 am-4:30 pm Central Time, Monday through Friday. You can also email firstname.lastname@example.org for general questions (please do not email your protected health information).
Yours Very Truly,
Board of Trustees
NECA-IBEW Welfare Trust Fund
Board of Trustees
NECA-IBEW Pension Trust Fund