Notices from Seafarers Health and Benefits Plan

August 2010

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SHBP Plans to Implement Changes to Comply With Affordable Care Act

On March 23, 2010, President Obama signed the Affordable Care Act into law. This new law is designed to reform the U.S. health care system by controlling skyrocketing health care costs, improving the quality of health care coverage, making health insurance available to more Americans and promoting preventive care. The changes required by the law will be implemented gradually over the coming years.

The Seafarers Health and Benefits Plan (SHBP) has been carefully monitoring requirements contained in the law and the recent regulations issued by the Department of Health and Human Services.

The Plan will be implementing several changes Jan. 1, 2011, in order to comply with the Affordable Care Act. The changes include:

• If you are an eligible participant, the Plan will offer coverage to your children up to age 26, regardless of whether the child is in school. In addition, the child does not have to live with you or be supported by you in order to be eligible for health coverage. Coverage will be offered even if your child is married.

• The Plan will not exclude coverage for a medical condition that your child had before the child was covered by this Plan.

• The Plan will eliminate lifetime limits on essential benefits.

The Seafarers Health and Benefits Plan will be sending detailed information to you about these changes later this year. If you have any questions about the changes, you may contact the Plan directly at 1-800-252-4674.

  • SHBP Announces Out-of-Network Savings Program

    The Trustees of the Seafarers Health and Benefits Plan (SHBP) are pleased to announce an enhancement to your benefits, which will go into effect Sept. 1, 2010.

    Three years ago, the Plan partnered with CIGNA HealthCare to provide access to CIGNA’s Network of more than 1 million “In Network” provider locations.

    On Sept. 1, 2010, we will be adding CIGNA’s Out-of-Network Savings Program. If you currently use out-of-network providers, this program may result in significant savings for you.

    This program supplements the current network by enabling Plan participants to receive discounts from many providers not covered by CIGNA’s network. While covered services received from these providers will be paid at the out-of-network benefit level of 65 percent, access to this supplemental network will provide our participants with the following:

    • Participants will have lower out-of-pocket expenses when they receive covered services from these out-of-network healthcare professionals.

    • There will be no additional paperwork. Seafarers participants will be issued a new ID card (see below) which should be presented as usual at time of service.

    • Claims will be submitted for reimbursement as usual. Discounts that may apply are automatically calculated. The explanation of benefits that you receive will show any discount that was applied and the reduction in the participant’s share for the covered service.

    • Participants are only responsible for costs up to the discounted amount. There will be no balance billing other than the applicable coinsurance payment of 35 percent, once you have satisfied the annual deductible.

  • During mid-August, 2010 you will be receiving a new SHBP ID card. This card will have the addition of the “Multi-Plan” logo. Please make sure that you discard your current card after Aug. 31. This new network of providers will go into effect Sept. 1, 2010. You must use the new card to receive the benefit of these additional discounts.

    You may wish to check with your out-of-network health care providers to see whether they participate in these additional networks. If you have any additional questions, feel free to contact the Plan at 1-800-252-4674.

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