U. S. Financial Meltdown Creates Global Crisis by igt11325

VIEWS: 10 PAGES: 16

									                                                                                                Winter 2008




 The Magazine of the Central States, Southeast and Southwest Areas Health and Welfare and Pension Funds




         U. S. Financial
        Meltdown Creates
          Global Crisis                                                         page 4




Fund Selects CVS Caremark as New Rx Provider         page 6

New Health Claim Explanation of Benefits (EOB) Launched page 7
New Website Ready to Roll back cover
                                          TEAMWORK MAGAZINE                                              Winter 2008


TEAMWORK® Published by the Trustees of
the Central States, Southeast and         Central States Funds
Southwest Areas Health and Welfare and
Pension Funds                             Letter from the Executive Director ………....................................... 3


Executive Director:
Thomas C. Nyhan
                                          Health Fund News
Union Trustees:
Fred Gegare, Jerry Younger,               Fund Selects CVS Caremark as New Prescription Drug Provider.... 6
George J. Westley, Charles A. Whobrey
                                          Fraud Eats Away Health Care Dollars ……...................................... 11
Employer Trustees:
Howard McDougall, Arthur H. Bunte, Jr.,   Fund Adds Voluntary Humana Dental PPO …...............…............. 13
Tom J. Ventura, Gary F. Caldwell

Editor:
William J. Schaefer

Web Site:
                                          Explanation of Benefits (EOB)
www.centralstates.org

Email via website or:
                                          New EOB Puts More Information at Your Fingertips …….…........7
bschaefer@centralstates.org

Send questions & comments to:
TeamWork
PO Box 5124
Des Plaines, IL
                                          Pension Fund News
60017-5124
                                          Recently Divorced? Change Your Beneficiary ....……….....…........11
For questions concerning
benefits, call 1-800-323-5000             New Joint and Surviving Spouse Option Available ............…........13
7:00 am - 5:30 pm Mon. - Thurs. CST
7:00 am - 4:30 pm Fri. CST                Retiree Health Coverage Deferral Option …………………............. 14
Central States, Southeast and Southwest Areas Health and Welfare and Pension Funds




        Dear Participants:
         Just a few short years ago, the U.S. stock market experienced three con-
         secutive years of negative returns, the first time since the Great Depres-
         sion. Now just five short years later, and with the Pension Fund still reel-
         ing from that previous major bear market, both U.S. and Foreign stock
         markets have gone into a tailspin.
             The current stock market freefall is of such magnitude that trillions of
         dollars in investment value has been wiped from the nation’s retirement
         security wealth. Domestic and foreign stock markets have seen record
         declines in their relative indexes. The S & P 500 has declined 36% in
         the past year and foreign markets are down even further with China
         down 65%, Europe down 48% and Japan down 39%. Estimates are that
         401(k)s have declined 42% or $2 trillion in value in the past year, while
         defined benefit plans (pension funds like the Central States Pension Fund)
         are estimated to have lost $1.8 trillion. Year-to-date the Fund is down
         28% through October 31, 2008. For the two month period of September
         and October 2008 alone, the Pension Fund lost 21%.
             The financial collapse has been so severe that the government has had
         to take unprecedented steps to bail out and control the nation’s banks to
         prevent a complete collapse of the financial markets.
             Clearly, the Pension Fund will end the year significantly down from
         last year. How this impacts the Fund’s Rehabilitation Plan is unclear at
         this time. But, we must remember to keep a long-term perspective, not a
         short-term one. If history tells us anything, it is that these financial mar-
         kets will recover and investment values will return to more traditional
         valuations. When this will happen is unknown and so is the magnitude
         of any recovery. Until then, the Pension Fund will continue on its path
         to invest for growth and income over the long-term.
             One thing is for certain. The impact of these losses will be felt for
         many years. The sharp decline in investment assets will leave many pen-
         sion funds teetering on insolvency. Congress will need to take action to
         restore retirement security to the nation’s workers.
             In the main article of this TeamWork issue we further explain the cause
         of the financial crisis and provide insight into its impact on the nation’s
         retirement security. The remainder of the magazine includes important
         information on your benefits and new service initiatives.

         Thomas C. Nyhan
         Executive Director
   TeamWork • Financial Meltdown




        U. S. Financial Meltdown
          Creates Global Crisis
S      ince reaching highs in October 2007, the stock
       market has dropped precipitously, falling to levels
       last seen in 2002. While American markets (S & P
500 Index) have fallen 38% since October 2007, foreign
                                                                The Housing Bubble Bursts
                                                                Then things changed. In 2003, the Federal Reserve Bank
                                                                started raising short-term interest rates. With increased
                                                                short-term rates going up, adjustable rate mortgages
markets have declined even further. This global market
collapse has caused investors to lose trillions of dollars in   began to reset at higher and higher interest rates. As
just a few short months. And, there was no safe haven as        mortgage interest rates go up, housing demand starts to
equities in every market world-wide saw values freefall.        decline and in mid-2006 home prices start dropping in
The impact is so far reaching that governments across the       value. Since many of these loans were supported by a very
world are taking unprecedented steps to inject trillions        small or even no down payment, it was easier for the
of dollars in investments and loans to shore up privately       homeowners to default on their mortgage and walk away
owned banks and corporations that are teetering on the          from their obligation.
brink of collapse.                                                  Banks and other financial institutions, holding bil-
    Retirement plans designed to provide income secu-           lions of dollars in the packaged debt investments, soon
                                                                find that they must write-down their stated value signifi-
rity to current and future retirees were not left out of the
                                                                cantly and investors quickly devalue the stocks of these
aftermath. The Center for Retirement Research at Boston
                                                                financial institutions. Financial stocks tailspin and banks
College estimates that retirement plans have lost $10
                                                                stop lending each other money. And, insurance compa-
trillion in the past year dropping 42% in value. 401(k)s
                                                                nies began to incur massive losses on the packaged loans
dropped $2 trillion in value from $4.7 trillion to $2.7
                                                                they insured. Soon a few large banks, IndyMac, Lehman
trillion while defined benefit plans (i.e., pension funds)
                                                                Bros., Bear Stearns fail. To avoid insolvency, Merrill
declined $1.8 trillion from $4.4 trillion to $2.6 trillion.
                                                                Lynch and Countywide, the largest mortgage lender,
    So now that we are here, with trillions of dollars van-
                                                                sell themselves to Bank of America. And, the Federal
ished into thin air, how did we get here and where are we
                                                                Government rescues AIG, Freddie Mac and Fannie Mae
headed?
                                                                to prevent total chaos. Investors around the world lose
                                                                confidence and fears of a global recession cause stocks
                                                                across the world to go into a freefall.
It all started with Cheap and Easy Money                            So the exact cause of the market collapse is really a
Early this decade, the Federal Reserve Bank continuously        series of events, a house of cards if you will. Regardless
lowered the interest rate that banks charge each other for      of the cause, the crisis is deep and wide. This crisis was
overnight loans. Known as the federal funds rate, it is a       years in the making and its effects, still largely unknown,
key barometer for the rate charged for short-term loans.        will be felt for years to come. And the nation’s commit-
Encouraged by these low rates, banks and mortgage com-          ment to encourage retirement savings above and beyond
panies offered cheap mortgages to all, including people         Social Security will now be tested.
who normally would not qualify (commonly referred to
as sub-prime loans).                                            401(k)s – Should our nation’s retirement
    Wall Street financial magicians, never shy to create a
new profit opportunity for themselves, created an invest-       system be so dependent on them?
ment offering that packaged the sub-prime loans with            It is estimated that 80% of working people invest in the
more traditional high-grade loans. To make the packaged         stock market through their 401(k) defined contribution
loans more attractive, underwriters bought insurance            plan. Experts also tell us that most 401(k) participants
policies guaranteeing the loans would be repaid. Credit-        are ill-prepared to properly invest their 401(k) assets and
rating agencies encouraged by the insurance policies            manage investment risk. 401(k) participants are now
rated the packaged loan investments, which included the         seeing the tremendous losses in their retirement savings
sub-prime loans, as triple-A, the highest possible rating.      when they receive their 401(k) investment statements in
                                                                             Financial Meltdown • TeamWork         




                                                            “ We are witnessing unprecedented market
                                                              conditions. We are in the midst of severe
                                                              global credit crunch that has extended to
                                                              all sectors of the economy. Global equity
the mail or online. This is causing much hand wring-
ing and concern about the future of retirement in             indexes down as much as 60% thus far in
America.                                                      2008, investors (401(k) and pension funds)
    Serious questions are now being raised about              find themselves caught in the jaws of a
government policy that for a generation has favored           severe and wrenching bear market. The
defined contribution retirement savings over defined
                                                              Dow Jones Industrial Average (DJIA) and the
benefit plans, such as the one Central States adminis-
ters.                                                         Standard and Poor’s 500 (S&P 500), the two
    Government policy has favored defined contribu-           most widely cited proxies for large capital-
tion plans like 401(k)s for some time. The attraction         ization stock performance, are down 33%
to these plans is simple. For employers, they are able
                                                              and 36% respectively this year. Moreover,
to shift all investment risk to employees. For employ-
ees, 401(k)s offer an excellent vehicle to accumulate         prospects for a meaningful recovery in the
retirement savings due to deferral of taxes; however,         stock prices are contingent on credit market
most employees do not save enough and are not prop-           improvements and better visibility on the
erly prepared to either invest or sufficiently manage         probable depth and duration of the unfolding
the associated investment risk.
                                                              economic recession.

Impact on Central States Pension                              The current bear market has destroyed
                                                              trillions of dollars in investment wealth,
The market collapse has been so wide-spread that all
investors across the world have seen unprecedented            impaired confidence in worldwide finan-
declines in their portfolio’s value. 401(k)s, the govern-     cial systems and exacerbated a developing
ment favored retirement vehicle, have been hit so hard        global economic recession. The damage to
that retirements will clearly need to be delayed for          investors’ balance sheets and psyches has
many years, maybe indefinitely. And, all defined ben-
efit plans, including the Central States Pension Fund,        been large, and the immediate prospects
were also hit with devastating declines in the value of       for financial and economic recover remain
their investment assets.                                      uncertain.
    Clearly, the Pension Fund will end the year sig-
nificantly down from last year. How this impacts              We continue to monitor the situation, but will
the Fund’s Rehabilitation Plan is unclear at this             remain disciplined to our long-term strate-
time. But, we must remember to keep a long-term               gic strategies. History shows us that equity
perspective, not a short-term one. If history tells us        markets usually bottom well in advance of
anything, it is that these financial markets will recover
and investment values will return to more traditional         improving business conditions. Accordingly
valuations. When this will happen is unknown and              we remain vigilant in assessing immediate
so is the magnitude of any recovery. Until then the
Pension Fund will continue on its path to invest for
                                                              portfolio risks, but focused on the long-term.   ”
growth and income over the long-term. For more
                                                              David J Dykstra
on this see the side-bar on this page from one of the
Fund’s investment fiduciaries, Northern Trust.                Senior Program Manager
    One thing is for certain, the impact of these losses      Northern Trust Global Advisors, Inc.
will be felt for many years. The sharp decline in in-         Central States Investment Fiduciary
vestment assets will leave many Pension Funds teeter-
ing on insolvency. Congress will need to take action
to restore retirement security to the nation’s workers.
   TeamWork • Health Fund News




                                        : Your New Rx Provider
                                                      Effective January 1, 2009
            The Fund is pleased to introduce CVS Caremark as its new TeamCareRx
         prescription drug benefit manager. The conversion to CVS Caremark is ef-
         fective January 1, 2009. Prior to this date, please continue to use your current
         TeamCareRx Prescription Drug ID Card. The Fund and CVS Caremark have
         been working closely together for several months to ensure that the transition
         will be as seamless as possible.
            It is very important to understand that there is no change to your drug benefit. The only
         change is the conversion to CVS Caremark – all other parts of your plan remain unchanged.
            In mid-December 2008, you will receive a Welcome Kit in the mail that contains more
         details about the CVS Caremark prescription program and the items you will need including your
         CVS Caremark benefit ID cards, a brochure and a short list of Frequently Asked Questions.
            As with your previous program, there are several components to your prescription program:

            Caremark Retail Program (Short-term Medicines)
            When filling prescriptions for short-term medicines, such as antibiotics, it is important that
            you continue to use a participating retail pharmacy to receive your full plan benefit. The
            Fund’s evaluation of CVS Caremark’s network would indicate that there is virtually no change
            from the previous Medco network. The Caremark Retail Program includes over 62,000
            participating pharmacies nationwide, including more than 20,000 independent community
            pharmacies. There is no need for you to get a new prescription unless your current retail pre-
            scription has expired, you have no refills remaining, or you decide to change retail pharmacies.

            CVS Caremark Mail Service Pharmacy (Long-term Medicines)
            The CVS Caremark Mail Service Pharmacy is the right choice for your long-term medicines
            because you will be able to receive up to a 90-day supply for a 20% copay, which is less than
            what you would pay for the same amount at retail. As part of the work leading up to this tran-
            sition, all mail service prescriptions were transferred from Medco to CVS Caremark. There is
            no need for you to get a new mail service prescription from your doctor unless your cur-
            rent mail service prescription has expired; you have no refills remaining; or if your prescription
            is for a controlled substance (i.e., a narcotic).

            Maintenance Choice™
            In early 2009, we will be rolling out an exciting new program called Maintenance Choice.
            With Maintenance Choice you will have the option of filling your long-term prescriptions
            through either the CVS Caremark Mail Service Pharmacy or at your local CVS/pharmacy store.
            And best yet, the price will be the same, meaning you will pay the mail service pricing even if
            you decide to have your long-term prescriptions filled at your local CVS/pharmacy store. More
            information on Maintenance Choice will be supplied early next year.
                                                                                              Continued on page 14



           Minute Clinic
           In addition to your new pharmacy program though CVS Caremark, our new affiliation with CVS Care-
           mark provides access to MinuteClinic available at many metropolitan CVS Pharmacy stores. With over
           500 locations at CVS Pharmacy stores and open seven days a week, Minute Clinics provide convenient
           access for treatment of common illnesses and general health screenings. To find out whether a
           MinuteClinic is near you, either go to www.minuteclinic.com or call 1-866-389-ASAP (2727).
                                                                                                                                                                                                                                                                                            New EOB • TeamWork                                             



                    NEW!
                                        Introducing Your All-New
                                 Explanation of Benefits (EOB) Statement
                                                                                     EFITS (EOB)
                                                                EXPLANATION OF BEN
                                                                       This is not a bill
                                                                                                                                                of
                                                                                                                       You can check the status
                                                                                                                                               website
                                                                                                                       submitted claims on our
                                      CENTRAL STATES                                                                   www.centralstates.org
                                                                                                                                               call
                                      SOUTHEAST AND                                                                    For 806999999 ions
                                                                                                                           additional quest                                                                 EXPLANATION OF BENEFITS (EOB)                                                                                           A12345678-00
                                      SOUTHWEST AREAS                                                                  1-800-323-5000
                                      HEALTH AND WELFARE
                                                         FUND                                                               Judith K Participant                                                                   This is not a bill                                                                                          Dr. John Johnson
                                                                                                               Member ID: 806999999                                                                      Office                                                                     Payable      Co-
                                                                                                                                   h A Participant
                                                                                                           Member Name: Josep    Service Dates                    Type of            Billed    Allowed   Visit                                         Eligible   Paid                By      Insurance Total You
                                                                                                                                    K Participant
                                                                                                            Patient Name: Judith
                                                                                                                              From
                                                                                                              Relationship: Wife
                                                                                                                                                To                Service           Amount     Amount Co-Pay Deductible                                Amount      At                Plan      You Owe    May Owe   Remarks
                                                                                                                             A12345678-00 7/20/08
                                                                                                                 Claim No.: 7/20/08                                 270                 180.00    100.00   20.00   0.00                                     80.00 100%                  80.00        0.00     20.00
                                                                                                                              7/20/08
                                                                                                             Service Date: 7/20/08            7/20/08               070                 100.00     60.00     0.00 20.00                                     40.00 80%                   32.00        8.00     28.00
                                                                                                                              8/1/08
                                                                                                             Process Date: 7/20/08
                                                NT                                                                                            7/20/08               000                  20.00      0.00     0.00  0.00                                      0.00                        0.00        0.00     20.00   1
                              JOSEPH A PARTICIPA                                                           Patient Acct No.:
                              123 MAIN ST                                                                      Local Union: 00071
                              ROSEMONT, IL 60018                                                                 Plan Type: MEDC6
                                                                                                                   Adjust er: AH5111


                                                                                         and Payments
                                                                      Summary of Charges
                                                                                       claim was processed,
                                                                                                            see reverse side) Totals                                                   $300.00         $160.00         $20.00            $20.00           $120.00                       $112.00               $8.00            $68.00
Pull Out and Save




                                                                       accounting of how this
                                               (For a more detailed                                  Other                                                        Amount
                                                                                         PPO       Insurance                                                      You May
                                           Blue Cross Blue Shield                                    (COB)        Type
                                                                                                                Previous of Service                                 Owe
                     TeamCare Network:                                         Total   Discount/                 270 nts &    Plan
                                                                                         Non-     Payments & Payme – Physician Charges To
                                                                                                                                   nt Paid                        Provider
                                                                               Billed                        s Adjustments Payme
                                                                                                                 070 – Xray/Lab
                                                                              Amount    Billable Adjustment           $0.00   $112.00 Provider
                                                                                                                                                                     $68.00
                                        Provider Name                                     $120.00        $0.00   000 – Noncovered items
                                                                               $300.00
                     Dr. John Johnson
                                                                Limits
                      Deductible   , Out of Pocket & Plan                                                        tible.
                                                                                                                             Remarks
                                                                                           0 annual family deduc Over the counter vitamins not covered.
                                                                                                                                                 ses.
                     Patient has used:                                $200.00 of the $400.0                          l family out of pocket expen
                                            0 annual deductible and                        7 of the $2,000.00 annua1 – Denied per Plan Section 12.07: These drugs are not covered under the Plan.
                       $200.00 of the $200.0                          expenses and $367.0
                                             .00 annual out of pocket
                       $367.07 of the $1,000         l Adult Wellness Benefi
                                                                              t limit.
                                               annua
                       $0.00 of the $1,000.00        l Chiropractic Benefit limit.
                                               annua
                       $0.00 of the $1,000.00                                 t limit.
                                                 ,000.00 annual Plan Benefi
                       $14,622.78 of the $1,000
                                                                                                              96                                     charge.
                                                                                  “ASK MAYO” 1-800-700-62health information from Mayo Clinic FREE of
                                                                                                      receive
                                                                                 medical problems and
                                                        this number to discuss
                                H&W Members can call
                                                                                                                       ES
                                                                                             APPEAL PROCEDUR                                                                      file an appeal,
                                                                                                                                                     claim. If you choose to                                          Definition of Terms Used on This Statement:
                                                                                                                         n concerning your benefit            file an appeal by printing
                                                                                                                                                                                               and
                                                                                          not agree with the decisio                  Type of You may
                                                                determination if you do                                      s determination. Service                                by letter, this
                                                                                                                                                                       Description of the type of services rendered to patient.
                                         to appeal this benefit                                from your original benefit                                If you file your appeal
                      You are entitled                              Fund within 180 days                                   contact theBilled by letter.
                                                                                                                                       Fund                                                 ship of
                                                                                                                                             Amount patient’s name; (5) relationby provider for services rendered.
                      you must send      a written appeal to the                 (www.centrals   tates.org) or you may
                                                                                                                                (3) claim number;    (4)               Charges billed
                                                     le on the Fund’s website                         identification number;
                      completing the form availab                         address; (2) member’s                                       Allowed Amount                   The charge(s) eligible under the benefit plan after negotiated PPO discounts or reasonable and customary limitations have been applied.
                                                  member’s name and                                      sfied.
                      letter must contain: (1)                                 reason you are dissati                                                                                   , you have
                                                date of loss; and (7) EXACT                                                                                            This denied the day
                                                                                                                                      Office Visit Co-Payfirst appeal ischarge is for each regular visit to a network physician’s office.
                      patient to member; (6)                                                                          a two step appeal proces
                                                                                                                                                 s. If your
                                                                                                                                                                        180 days from
                                                                                          and Welfare Fund has                           your second appeal within Amount applied to your plan’s annual deductible that must be met before your benefit plan begins paying benefits.
                                                              Southwest Areas Health                             appeal, you must fileDeductible                              Section 502(a) of
                       The Centra  l States, Southeast and                             to file a second level                                 the right to bring suit under                          t
                                                             appeal. If you choose                                  is denied, you will have                           of charge upon reques
                       the right to file a second and final                  . If your second and final appeal                        Eligiblewill be provided free Amount eligible for benefits calculated as the Allowed Amount minus the Office Visit Co-Pay and/or the Deductible. This may be reduced for amounts over plan maximums.
                                                                                                                               determination    Amount                                    medically
                                                   first appeal was denied                           in the adverse benefit                                   the treatment was not
                       you are notified that your                         or protocol relied upon                                 on a determination that              The percentage for this
                                                                                                                                                                                          nt
                                                 specific rule, guideline                              may have been based            Paid At            scientific or clinical judgme of the Eligible Amount which is payable according to your benefit plan. Remaining percentage is the Co-Insurance You Owe.
                       ERISA. A copy of the                                   benefit determination                              an explanation of the
                                                ized representative. Your constituted experimental treatment. If so,
                        by you or your author                               ent                                                       Payable By Plan                  The amount your benefit plan will pay. (This amount may be reduced when Other Insurance is involved.)
                                                    ination that the treatm                             t.
                        necessary or on a determ d to you free of charge upon written reques
                                                                                                                                      Co-Insurance You Owe             Portion of charges you are responsible for after your plan has paid its required benefit. (For example, if the Paid At amount is 80%, patient co-insurance is 20%.)
                        determination will be provide
                                                                                                     to:
                                                                          nes should be directed                                      Total You May Owe                The amount you may be responsible to pay. (Includes Office Visit Co-Pay + Deductible + Co-Insurance + non covered items + amounts over plan maximums). Deduct any
                                                 explanations, or guideli
                        Requests for appeals,                                                                                           AREAS                          amounts you may have already paid to the provider, including Office Visit Co-Pay. When other insurance is involved, refer to the Amount You May Owe Provider on the front of this
                                                                                                           EAST AND SOUTHWEST
                                                                         CENTRAL STATES, SOUTH WELFARE FUND                                                            statement.
                                                                                          HEALTH AND
                                                                                                                      ce DepartmentOther Insurance
                                                                                    Research and Corresponden                                                          Payment by primary carrier plus discounts (Coordination of Benefits).
                                                                                                      PO Box 5111
                                                                                                                            5111      Plan Payment                     This is the check amount – it may be less than the Payable by Plan amount when other insurance and/or previous paid amounts apply.
                                                                                           Des Plaines, Illinois 60017-



                                                                                                              claim detail
                                                                              See reverse side for




                             ver the last year, we have been working to make the new Explana-
                             tion of Benefit (EOB) statement a reality. Very soon participants                                                                                                                                                                                        Easier to read state-
                             will begin receiving these all-new EOBs.                                                                                                                                                                                                                 ment with all your
                                We believe the new statements will make it much easier to                                                                                                                                                                                             important information
                    understand what Central States has paid, what the patient’s share is, and                                                                                                                                                                                         summarized right at
                    why a service may not be covered under the Plan. We have also added health                                                                                                                                                                                        your fingertips.
                    benefit accumulators for deductibles, out-of-pocket expense limits and vari-                                                                                                                                                                                      Enhanced detail
                    ous other plan limits to keep you current on your respective balances.                                                                                                                                                                                            regarding deductibles,
                       The new medical and dental EOBs have been moved to a two-sided                                                                                                                                                                                                 out-of-pocket expens-
                    format. Some participants want to simply see a summary of how their claim                                                                                                                                                                                         es, and benefit limits.
                    was processed, which is what you will find on the front of the EOB. If you
                    would like to see a detailed line item explanation of how the claim was                                                                                                                                                                                           Important messages
                    processed, see the reverse side. The reverse side also includes a section for                                                                                                                                                                                     and definitions to
                    remarks which include messages about how the claim was processed and a                                                                                                                                                                                            help you understand
                    definition section for explaining the columns and calculations.                                                                                                                                                                                                   how your claim was
                       We have included a step by step guide in the next few pages on how to                                                                                                                                                                                          processed.
                    read your new EOB. You can also find this information on our website at
                    www.centralstates.org.
   TeamWork • New EOB



                     A Step-By-Step Guide To Understanding Your All-New EOB

                                                                               Front
                                                             EXPLANATION OF BENEFITS (EOB)
                                                                    This is not a bill
                                                                                                                  You can check the status of
                                 CENTRAL STATES                                                                   submitted claims on our website
                                 SOUTHEAST AND                                                                    www.centralstates.org
                                 SOUTHWEST AREAS                                                                  For additional questions call
                                 HEALTH AND WELFARE FUND                                                          1-800-323-5000

                                                                                                         Member ID:      806999999
                                                                                                     Member Name:        Joseph A Participant
                                                                                                      Patient Name:      Judith K Participant
                                                                                                        Relationship:    Wife
                                                                                                          Claim No.:     A12345678-00
                                                                                    1                  Service Date:     7/20/08
                       JOSEPH A PARTICIPANT
                                                                                                      Process Date:      8/1/08
                       123 MAIN ST
                                                                                                    Patient Acct No.:
                       ROSEMONT, IL 60018
                                                                                                        Local Union:     00071
                                                                                                          Plan Type:     MEDC6
                                                                                                            Adjuster:    AH5111

                                                         2    Summary of Charges and Payments
                                  (For a more detailed accounting of how this claim was processed, see reverse side)
                                                                                      Other                                                                           3
          TeamCare Network: Blue Cross Blue Shield                      PPO         Insurance                                                             Amount
                                                             Total    Discount/       (COB)     Previous                                                  You May
                                                             Billed     Non-       Payments & Payments &       Plan                                         Owe
                           Provider Name                    Amount     Billable Adjustments Adjustments Payment Paid To                                   Provider
          Dr. John Johnson                                   $300.00    $120.00           $0.00       $0.00    $112.00 Provider                              $68.00

           Deductible, Out of Pocket & Plan Limits
          Patient has used:
           $200.00 of the $200.00 annual deductible and $200.00 of the $400.00 annual family deductible.
           $367.07 of the $1,000.00 annual out of pocket expenses and $367.07 of the $2,000.00 annual family out of pocket expenses.
           $0.00 of the $1,000.00 annual Adult Wellness Benefit limit.
           $0.00 of the $1,000.00 annual Chiropractic Benefit limit.                                                                                         4
           $14,622.78 of the $1,000,000.00 annual Plan Benefit limit.


                                                                 “ASK MAYO” 1-800-700-6296
                    H&W Members can call this number to discuss medical problems and receive health information from Mayo Clinic FREE of charge.

      1   Claim Information: Includes the member and patient information, claim number, local union, and plan
                                                      APPEAL PROCEDURES

          type. When contacting Central States about a claim, please make sure to indicate the Member’s ID and claim
          You are entitled to appeal this benefit determination if you do not agree with the decision concerning your benefit claim. If you choose to file an appeal,
          you must send a written appeal to the Fund within 180 days from your original benefits determination. You may file an appeal by printing and
          number.
          completing the form available on the Fund’s website (www.centralstates.org) or you may contact the Fund by letter. If you file your appeal by letter, this
          letter must contain: (1) member’s name and address; (2) member’s identification number; (3) claim number; (4) patient’s name; (5) relationship of
          patient to member; (6) date of loss; and (7) EXACT reason you are dissatisfied.
      2   Summary Of Charges: Highlights the major financial information— network, provider, billed amount,
          The Central States, Southeast and Southwest Areas Health and Welfare Fund has a two step appeal process. If your first appeal is denied, you have
          the right to file a second and final appeal. If you choose to file a second level appeal, you must file your second appeal within 180 days from the day
          discounts, other insurance payments, plan payment, and amount you may owe provider.
          you are notified that your first appeal was denied. If your second and final appeal is denied, you will have the right to bring suit under Section 502(a) of
          ERISA. A copy of the specific rule, guideline or protocol relied upon in the adverse benefit determination will be provided free of charge upon request
          by you or your authorized representative. Your benefit determination may have been based on a determination that the treatment was not medically
      3    Amount You May Owe Provider/Total You May Owe: This is the amount you may be re-
          necessary or on a determination that the treatment constituted experimental treatment. If so, an explanation of the scientific or clinical judgment for this
          determination will be provided to you free of charge upon written request.
           sponsibleappeals, explanations, or guidelinesincludes directed to: Co-Pay plus Deductible plus Co-Insurance plus non-cov-
          Requests for for paying. This amount should be Office Visit
           ered items plus amounts over plan maximums. When other insurance is involved, the Total You May Owe on the
                                                  CENTRAL STATES, SOUTHEAST AND SOUTHWEST AREAS
                                                                HEALTH AND WELFARE the
           back is reduced and the corresponding amount is reflected inFUND Amount You May Owe Provider on the front. In
                                                            Research and Correspondence Department
                                                                          PO paid the
           addition, deduct any amounts you may have alreadyBox 5111 provider, including office visit co-pay.
                                                                       Des Plaines, Illinois 60017-5111


      4   Accumulators: Deductibles, out-of-pocket expenses, and benefit/plan limits indicate how much the
                                                 See claim process date. The accumulators listed are for the calendar year
          patient has met and still has left as of thereverse side for claim detail
          in which the service dates fall.
                                                                                                                                                                                  New EOB • TeamWork               



                 A Step-By-Step Guide To Understanding Your All-New EOB

                                                                                                        Back
    806999999                                5                                   EXPLANATION OF BENEFITS (EOB)                                                                                    A12345678-00
    Judith K Participant                                                                This is not a bill                                                                                   Dr. John Johnson
                                                                             Office                                                                 Payable      Co-
         Service Dates                 Type of           Billed    Allowed   Visit                                      Eligible   Paid               By      Insurance Total You
       From         To                 Service          Amount     Amount Co-Pay Deductible                             Amount      At               Plan      You Owe    May Owe   Remarks
      7/20/08     7/20/08                270                180.00    100.00   20.00   0.00                                  80.00 100%                 80.00        0.00     20.00
      7/20/08     7/20/08                070                100.00     60.00     0.00 20.00                                  40.00 80%                  32.00        8.00     28.00
      7/20/08     7/20/08                000                 20.00      0.00     0.00  0.00                                   0.00                       0.00        0.00     20.00   1




                       Totals                               $300.00        $160.00         $20.00          $20.00          $120.00                      $112.00              $8.00           $68.00

     Type of Service
    270 – Physician Charges
    070 – Xray/Lab
    000 – Noncovered items


     Remarks
    Over the counter vitamins not covered.
    1 – Denied per Plan Section 12.07: These drugs are not covered under the Plan.



                                                                                                                 6

                                                                               Definition of Terms Used on This Statement:
    Type of Service
    Billed Amount
                               Description of the type of services rendered to patient.
                               Charges billed by provider for services rendered.
                                                                                                                                                                       7
    Allowed Amount             The charge(s) eligible under the benefit plan after negotiated PPO discounts or reasonable and customary limitations have been applied.
    Office Visit Co-Pay        This charge is for each regular visit to a network physician’s office.
    Deductible                 Amount applied to your plan’s annual deductible that must be met before your benefit plan begins paying benefits.
    Eligible Amount            Amount eligible for benefits calculated as the Allowed Amount minus the Office Visit Co-Pay and/or the Deductible. This may be reduced for amounts over plan maximums.
    Paid At                    The percentage of the Eligible Amount which is payable according to your benefit plan. Remaining percentage is the Co-Insurance You Owe.
    Payable By Plan            The amount your benefit plan will pay. (This amount may be reduced when Other Insurance is involved.)
    Co-Insurance You Owe       Portion of charges you are responsible for after your plan has paid its required benefit. (For example, if the Paid At amount is 80%, patient co-insurance is 20%.)
    Total You May Owe          The amount you may be responsible to pay. (Includes Office Visit Co-Pay + Deductible + Co-Insurance + non covered items + amounts over plan maximums). Deduct any
                               amounts you may have already paid to the provider, including Office Visit Co-Pay. When other insurance is involved, refer to the Amount You May Owe Provider on the front of this
                               statement.
    Other Insurance            Payment by primary carrier plus discounts (Coordination of Benefits).
    Plan Payment               This is the check amount – it may be less than the Payable by Plan amount when other insurance and/or previous paid amounts apply.




5   Claim Detail Section: Shows the service dates, types of service, and the breakdown of how the plan
    benefit was applied.

6   Remarks: This section indicates important messages related to how the claim was processed, including
    denial reasons, if any.

7   Definition Of Terms: Explains what each column means and how the amounts were calculated.
10   TeamWork • New EOB


          Frequently Asked Questions

          Q: Why“Amount You MayMay Owe” on the backfront? amount than
             the
                 is the “Total You
                                   Owe Provider” on the
                                                        a different


          A:       The detailed section on the back of the EOB shows how the claim was processed,
                   without COB (other insurance) and adjustments. The summary section on the front of
                   the EOB takes into consideration other insurance payments and adjustments, which
                   could lower the amount the patient is responsible to pay.




          Q: Where do I look to see why a service was denied?
          A:       The “Remarks” section on the back of the EOB will have an explanation of why a par-
                   ticular service was not covered by your Plan.




          Q: On the back of the shows 100%? “Paid At” show 80% but the
             “Payable By Plan”
                                EOB, why does


          A:       “Paid At” indicates the percentage payable by your benefit Plan without regard to any
                   out-of-pocket maximum. “Payable By Plan” may be higher if you have met your out-
                   of-pocket expense for the year.



          Q: Iand plan limit the samethe same process date. Why is my deductible
               have three EOBs with
                                      on all three EOBs?

          A:       The deductible, out-of-pocket expense, plan limit, etc. are calculated at the end of each
                   process date and applied to all claims which are processed on that date.




          Q: Imean andOut-of-Network penalty applied to my claim. What does this
               have an
                       how are my future benefits affected?

          A:       Out-of-Network penalties are applied to claims when a TeamCare provider is not
                   utilized. The use of TeamCare providers is required, except in the following three cases:
                   Your claim was a result of an emergency; Your claim was the result of an out-of-net-
                   work referral by a TeamCare physician; Your claim was for a dependent who resides
                   outside a TeamCare area.


             If you have questions or need additional assistance understanding your new and improved EOB,
            please do not hesitate to contact us through Participant Services at 1-800-323-5000. You can also
                       check the status of submitted claims on our website www.centralstates.org.
                                                                                             Health Fund News • TeamWork            11


Fraud Eats Away Health Care Dollars
T        he Federal Government conservatively estimates
         that at least 3% of each health care dollar each year
         is lost to fraud. Your Fund spends more than $1
billion on health care every year, so if the Fund also lost 3%
to fraud – that would be more than $30 million! While the
                                                                       ing of all paid claims, review of the National Healthcare
                                                                       Antifraud Association’s database that contains posting
                                                                       from healthcare insurance underwriters relating to suspect
                                                                       providers, and participating in quarterly forums with the
                                                                       country’s largest insurance companies and law enforcement
Fund aggressively pursues every avenue possible to prevent             agencies that meet to discuss current fraudulent cases and
fraud, many are very difficult to prevent. Fraud loss directly         trends. The Fund also receives tips from the claims process-
impacts you, as participants in the Fund, through higher               ing area and from participants.
health care costs and higher contributions. Additionally,
health care fraud often hurts many of you who may be sub-              How you can help stop fraud
jected to unnecessary or unsafe procedures or who may be               Read all Explanation of Benefits (EOB) statements and
the victims of identity theft.                                         any paperwork you receive from the Fund. Make sure you
    The most common kind of fraud involves a false provid-             actually received the treatments for which the Fund was
er statement, misrepresentation or deliberate omission that            charged, and question suspicious expenses.
is critical to the determination of benefits payable. The
most common fraudulent acts include, but are not limited               Beware of “free” offers. Offers of “free” services are
to:                                                                    often fraud schemes designed to bill the Fund illegally
                                                                       for thousands of dollars of treatments you never received.
   Billing for services, procedures and/or supplies that were
                                                                       These “free services” often result in thousands of dollars in
   never provided or performed.
                                                                       claims being billed to the Fund. The Health and Welfare
   Intentionally misrepresenting services, procedures, treat-          Fund has several staff dedicated to stopping the Fund from
   ments and supplies, for purposes of obtaining a payment             paying fraudulent claims. For the past several years they
   — or a greater payment — to which one is not entitled.              have prevented millions of dollars in fraudulent claims from
   Deliberate performance of medically unnecessary services.           being paid.
                                                                       Protect your health insurance card like your credit
What the Health & Welfare Fund does to
                                                                       card. Don’t give your Subscriber Identification No. (UMI)
identify fraud
Each day’s claims are reviewed by a group of trained fraud             or other identifying information to anyone except legiti-
specialists for the following:                                         mate health care providers. Never give your health insur-
  Claims from known fraudulent providers                               ance card to telephone or email solicitors.
  Claims fitting a pattern of known fraud schemes                      How to report fraud
  Unusual claims based on dollar amount, location of the               Call the Fund immediately (1-800-323-5000) if you sus-
  provider in relation to the participant, and unusual diag-           pect you may be a victim. Contact your State Insurance
  noses or procedures                                                  Fraud Bureau. File a complaint with the State Medical
Fraudulent providers are also identified through data min-             Boards.


    Recently Divorced? Change Your Beneficiary
    Changes have been made to the Health and Welfare Plan              In addition, if you subsequently remarry, the Fund will
    which affect participants who get divorced or re-married.          send another beneficiary form for completion.
    If you get divorced, any life insurance beneficiary designa-       To ensure proper claim payment and prevent any over
    tion you have on file before the divorce date becomes invalid.     payment, it is important that you notify the Fund immedi-
    When the Fund is notified by you of your divorce, a new ben-       ately of any changes to your marital status.
    eficiary designation form will be sent for completion.
                                                                       In order for a beneficiary form to be considered valid, it
    If you die without supplying an updated beneficiary form, the      must be signed and dated. You can fax your beneficiary
    Life Insurance Benefit will be paid to the first surviving class   form to our Life Insurance Department at: 847-518-9874.
    as follows:
                                                                       If you have any questions regarding these procedures,
         • Spouse                                                      please contact the Fund at 1-800-323-5000.
         • Equal shares to children
         • Equal shares to parents
         • Equal shares to siblings
         • Estate
12   TeamWork • Pension Fund Notice


Notice of Application For An Extension of an Amortization Period To Employee
  Organizations (Unions), Participants, Beneficiaries, And Alternate Payees
     This notice is to inform you that an application for an extension of an amortization period for unfunded liability under
     § 431(d) of the Internal Revenue Code (“Code”) and § 304(d) of the Employee Retirement Income Security Act of 1974
     (“ERISA”) is being submitted to the Internal Revenue Service (“Service”) for the Central States, Southeast and Southwest
     Areas Pension Plan (“the Plan”) for the plan year beginning January 1, 2008.
     By letter dated July 13, 2005 (“Letter”), the Internal Revenue Service granted an extension of the period for amortizing
     unfunded liabilities described in section 412(b)(2)(B) of the Code prior to its amendment by the Pension Protection Act of
     2006 (“PPA”). The letter granting the relief is conditioned, among other things, on the Plan’s maintaining specific funded
     ratios for years after issuance of the Letter. Due to the severe and unexpected market downturn – unless there is a very sig-
     nificant market recovery between now and the end of 2008 – the Plan will not be able to meet the required funded ratio for
     the 2008 plan year. Accordingly, the Plan intends to seek modifications of the Letter. Under sections 431(b)(4) and 431(d)
     of the Code, as amended by the PPA, such a request is considered an extension for request for amortization period under
     section 431(d) of the Code (and 304(d) of ERISA).
     Under § 431(d)(3)(B) of the Code and § 304(d)(3)(B) of ERISA, the Service will consider any relevant information sub-
     mitted concerning this application for an extension of the amortization period for unfunded liability. You may send this
     information to the following address:
     Director, Employee Plans
     Internal Revenue Service
     Attn: SE:T:EP:RAT:A2
     1111 Constitution Avenue, N.W.
     Washington, D.C. 20224

     Any such information should be submitted as soon as possible after you have received this notice. Due to the disclosure
     restrictions of § 6103 of the Code, the Service can not provide any information with respect to the extension request itself.
     In accordance with § 104 of ERISA, annual financial reports for this plan, which include employer contributions made
     to the plan for any plan year, are available for inspection at the Department of Labor in Washington, D.C. Copies of such
     reports may be obtained upon request and upon payment of copying costs from the following address:
     Public Disclosure Room
     Room N-1513
     Employee Benefits Security Administration
     U.S. Department of Labor
     200 Constitution Avenue, NW
     Washington, D.C. 20210

     In addition, pension plan actuarial information filed for 2008 and later plan years filed with the Department of Labor will
     be available in the future at http://dol.gov/ebsa/actuarialsearch.html.
     As required by § 104(b)(2) of ERISA, copies of the latest annual plan report are available for inspection at the principal
     office of the plan administrator, located at 9377 W. Higgins Road, Rosemont, IL 60018. As required under § 101(k)(1)
     of ERISA, copies of periodic actuarial reports, quarterly, semi-annual, or annual financial reports, and copies of any applica-
     tion for extension under § 304(d) of ERISA or § 431(d) of the Code may be obtained upon request and upon payment of a
     copying charge of no charge by writing to the plan administrator at the above address.
     The following information is provided pursuant to § 304(d)(3) of ERISA and 431(d)(3) of the Code:
     Present Value of Vested Benefits $34,701,168,890.
     Present Value of Benefits, calculated as though the plan terminated $44,317,409,000.
     Fair Market Value of Plan Assets $26,805,847,000.
     The Present Value of Vested Benefits was calculated as of January 1, 2008 using an interest rate of 7.5%. The Present
     Value of Benefits, calculated as though the plan terminated, was calculated as of December 31, 2007 using an interest rate
     of 5.37% for the first 20 years and 5.04% thereafter and includes an allowance for expenses. The Fair Market Value of Plan
     Assets is as of December 31, 2007.
     Thomas C. Nyhan
     Executive Director
                                                                                                                 Pension Fund News • TeamWork                         13



New Joint and Surviving Spouse Option Available
Participants who retire now have greater flexibility and                               sion benefit of $1,315.50 for a 50% JSO or $1,931.62 for
security in providing for their surviving spouses. Starting                            a 75% JSO. These JSO options give you greater flexibility
in February 2008, the Pension Fund began offering two                                  to provide security for your spouse by having increased
Joint and Surviving Spouse Options (JSO), a 75% JSO                                    retirement income.
and a 50% JSO.                                                                             Both JSO alternatives include the restoration feature,
   These JSO options can have a significant impact on a                                commonly known as JSO Pop-up, which restores the
participant’s and their surviving spouse’s pension benefit.                            retiree’s benefit to the full amount in the event the spouse
Below is an example showing how both Joint and Surviv-                                 pre-deceases the retiree. Participants and spouses can con-
ing Spouse Option are calculated.                                                      tinue to waive both JSO alternatives if they desire. If you
   The example shows that, upon the participant’s death,                               are near retirement, please contact the Fund to determine
the surviving spouse will receive a monthly lifetime pen-                              your benefit payable with and without the JSO options.


  Retirements after February 1, 2008
                                                                                                                                             Surviving Spouse’s
                                                                                                                  Member’s Monthly            Monthly Pension
        JSO           Member’s             Spouse’s          Monthly Pension         Calculation of Joint          Pension Benefit            Benefit Amount
      Election          Age                  Age             Benefit Amount           & Survivor Option           Amount With JSO               With JSO**

        50%                60                  57                        $3,000          $3,000 x .9010*                   $2,703.00                   $1,315.50

        75%                60                  57                        $3,000          $3,000 x .8585*                   $2,575.50                   $1,931.62

* The reduction factor used takes into account the specific ages of the participant and their spouse at retirement. All reduction factors are designed to cover the
  cost of providing the participant’s spouse with a lifetime survivor benefit.
** Upon the participant’s death, their spouse would receive a survivor benefit for the remainder of their lifetime.




                 TeamCareDental:
 Fund Expands TeamCare Program to Include Voluntary
            Humana Dental PPO Network
On July 1st, the Fund introduced TeamCare-                                                                in TeamCareDental. For those that don’t
Dental, a preferred provider program (PPO).                                                               participate, you have the option of staying
This program combines the Fund’s excellent                                                                with your current dentist or switching to
dental benefits with Humana’s nationwide                                                                  a participating dentist. You should have
dental PPO network of over 105,000 practice                                                               received an introductory letter and two ID
locations. While completely voluntary, if you                                                             cards along with a brochure that explains
choose to use Humana dental providers, you                                                                the program. There is no provider directory,
will see your dental benefits stretched due                                                               but you can either call Humana at 1-800-
to discounted fees, reduced co-insurance and                                                              592-3112 or go online to www.Humana-
protection from being billed for charges in ex-                                                           DentalNetwork.com to locate a TeamCare-
cess of “reasonable and customary” amounts.                                                               Dental provider near you.
You may find your dentist already participates
1   TeamWork • Health Fund News
                                                             Continued from page 6


     New Policy:                                                                     :Your New Rx Provider

     Retiree Health Coverage
                                                                  CVS Caremark Specialty Pharmacy
     Deferred Option                                              (Chronic illnesses)
                                                                  The specialty pharmacy is designed for indi-
     After hearing from our retirees and our Local
                                                                  viduals with chronic or genetic conditions. This
     Union partners, the Board of Trustees has ap-
                                                                  benefit offers convenient delivery of your specialty
     proved a policy allowing retirees to defer their
                                                                  medicines, personalized service and educational
     Retiree Health Plan coverage in the event they are
                                                                  support for your specific therapy. CVS Caremark
     covered by other insurance.
                                                                  assigns a team of professionals to help you suc-
        Effective August 1, 2008, current and fu-
                                                                  cessfully manage your condition and improve
     ture retirees and their spouses, under the Retiree
                                                                  your quality of life. This service includes 24-hour
     Health Plan (Plan R4 and UPS Plan R6) may
                                                                  access to a clinical pharmacist for consultation at
     both elect on a one-time basis to defer their Retir-
                                                                  no cost to you.
     ee Health Plan coverage to a later date, provided
     they have other insurance coverage.
                                                                  CVS ExtraCare® Health Card
                                                                  With the transition also comes a new value-added
     Here’s how it works
                                                                  feature – the CVS ExtraCare Health Card – for
     If the retiree and/or spouse have other insurance
                                                                  use at all CVS retail pharmacies. The ExtraCare
     coverage they may elect to defer their Retiree
                                                                  Health Card provides you and your family with
     Health coverage. The election to defer coverage
                                                                  a 20% discount on many CVS branded health
     is only available on a one-time basis. To defer
                                                                  related products, from cough and cold medicine
     coverage, the retiree must complete a Retiree
                                                                  to pain and allergy relief. The ExtraCare Health
     Health Plan election form and include proof of
                                                                  Card could save you and your family hundreds
     other insurance.
                                                                  of dollars each year. Your ExtraCare Health Card
         Upon approval, Central States will suspend
                                                                  and additional information concerning its use
     the retiree’s and/or spouse’s coverage and monthly
                                                                  will be mailed in January 2009.
     contribution payment as appropriate. The cover-
     age and monthly contribution payment will                    For those who are currently using mail service
     remain suspended until the retiree requests reacti-      or those with chronic conditions using a “specialty
     vation. At the time of reactivation, proof of insur-     pharmacy,” you will receive a separate mailing dur-
     ance termination must be supplied. The Fund              ing December 2008 that will provide additional
     will accept either a letter or a HIPAA Certifica-        information unique to your needs.
     tion of Continuous Coverage from the insurance               To ensure your safety and the accuracy of your
     company as proof of termination.                         prescriptions, CVS Caremark follows very strict
                                                              quality and safety standards to help protect you
     Two important things to remember                         from medicine interactions, allergic reactions and
         Upon reactivation, the retiree and/or spouse         incorrect dosages. There are hundreds of manual and
         will be required to pay the prevailing contri-       automated safety checks in place to help you receive
         bution rate based upon the retiree’s original        the best pharmacy care.
         retirement date. For example, a retiree who              Finally, please note that the conversion to
         retirees at age 57 but defers his/her cover-         CVS Caremark does not go into effect until Janu-
         age until age 60 will be required to pay the         ary 1, 2009. Both we at the Fund and our partners
         prevailing age 57 contribution rate, or stated       at CVS Caremark are working to assure you that this
         differently, the age 57 rate required at the time    transition goes very smoothly and without any un-
         his/her coverage is reactivated.                     necessary effort on your part. That said, should you
         In all cases, upon reactivation contributions        have questions or concerns specific to your situation,
         will be required retroactively to the date other     please do not hesitate to contact either the Fund toll-
         insurance coverage ceases.                           free at 1-800-323-5000 or CVS Caremark toll-free at
                                                              1-888-483-2650.
     If you have any additional questions regarding the           As always, your support and cooperation is
     deferral of Retiree Health Plan coverage, please         greatly appreciated.
     contact the Fund.
                                                                                                                  TeamWork           1
                                                                                                 ks”
Continued from back page
                                                                            ed –   within 3 clic
www.centralstates.org                                   “Info you ne
   Family Claim Summary
        History of you and your covered dependents paid                     We Want To Hear From You
        claims                                                         We want to make our website as user friendly as possible.
        Current totals of individual and family Deductible,            Any suggestions to improve the site are welcome. Please
        Out of Pocket and other plan limits such as Chiro-              click the “Feedback” link in the lower right corner of the
        practic and Dental                                                       Funds’ site to send us your suggestions.
   Locate TeamCare Physician or Dentist
   Request ID cards
   Frequently Asked Questions and Answers regarding                  Reference Materials and Links
   your Health benefits                                                Plan Documents and Summary Plan Descriptions
   Download and Print your Explanation of Benefits                     Fund Forms like Pension Application, Enrollment
   (to be added approximately March 2009)                              Forms, Loss of Time application, Appeals form, etc
                                                                       Reference past Fund publications like TeamWork
Pension Benefit Information and                                        Links to web sites: Social Security, Teamster, and the
                                                                       Fund’s various PPO programs
Future Benefit Estimator
   Complete work history of your pension contributions               The Funds know how valuable your time is – and with
   submitted to the Fund                                             dramatic improvements in navigation, appearance, and ac-
   Pension Estimator that will allow you to project what             cessibility we hope that you will find many of the answers
   your future pension benefit will be with the Fund                 you need right at your fingertips 24/7. The new website
   Frequently Asked Questions and Answers regarding                  compliments the Funds’ continuing efforts to improve
   your Pension benefits                                             service to you and your family members. The Funds con-
   Tax Estimator that will allow you to project what your            tinue to be different by providing you with the personal
   Federal tax will be on your future pension benefit                attention and service that you deserve.



             Women’s Health &
              Cancer Rights
  Under the Women’s Health Act, group health plans, insurance
  companies and health maintenance organizations (HMOs)
  offering mastectomy coverage must also provide coverage for
  reconstructive surgery in a manner determined in consultation
  with the attending physician and the patient. Coverage includes
  reconstruction of the breast on which the mastectomy was
  performed, surgery and reconstruction of the other breast to        Plan                      Deductible Copayment
  produce a symmetrical appearance, and prostheses and treat-         C6                             $200             0%
  ment of physical complications at all stages of the mastectomy,
  including lymphedemas.                                              C4                             $200             10%
                                                                      Modified C4 (MK/M9)            $250             10%
  Your Central States’ health plan includes this coverage for
  participants and their eligible dependents. Benefits may be         A/B                            $200             20%
  subject to certain deductibles and/or co-payments, which            S                              $500             20%
  will vary according to the plan under which you are covered.        MM 100 (MA)                    $100             20%
  The deductible and/or co-payment required for reconstructive
  breast surgery is the same as that required for other surgeries.    MM 200 (MB/TA)                 $200             20%
                                                                      MM 500                         $500             20%
  Other plan limitations may also apply. The deductible and co-
  payment requirements are summarized at right.                       Retiree Health Plan (R4/R6)    $100             20%
Fund Introduces New Website
                                                                                   .org
                                                                       t ralstates
                                                               www.cen              clicks”
                                                                                         within 3
                                                                             eed –
                                                                 “Info you n
                                                                    tion, it had become difficult for members and Locals
                                                                     to navigate.”
                                                                         The Funds designed the new website so in most
                                                                     cases members can find the information they need
                                                                     within “3 clicks.” “Understanding how frustrating
                                                                     it is not find to the information you need quickly, we
                                                                     designed our ‘3 click website’ so that members can
                                                                     get their pension and health information with ease,”
                                                                     said Sam Bentum-Siripi, the Funds’ web developer.
                                                                         After the initial login, you will be directed to
                                                                     your personalized home page that will contain benefit
                                                                     information specific to you and your family. From
                                                                     your home page, we’re putting your benefit informa-
                                                                     tion right at your fingertips and our online tools will
A    fter hear-
     ing from
our members on
                                                                     make it easy to get the most out of your health insur-
                                                                     ance and pension benefits. Some of the new web site
                                                                    features include:
what you wanted
to see on the Central States website — we are pleased to        Improved Navigation
announce that a new and improved version will be available
                                                                 Never get lost with our “Always There” menu
in just a few short weeks.
                                                                 Get where you want to be in “3 clicks” or less
    A recent Fund survey showed that nearly 75% of the
Funds’ members use the website to get information on             Easier look and feel to the new page layout
their pension or health and welfare benefits. Based on how       Email the Fund 24/7 with questions and receive fast
popular the website has become, the Funds began working          responses
with members and Local Unions earlier this year to under-
stand how the website could best serve them.                    Health Benefit Information and
    “The number one concern that the Funds heard was the        Claims Summary
need to make it easier to locate what people were looking        Information on your plan of benefits — including a de-
for on our site,” said Ray Hale, Director of Strategic Plan-     tailed explanation of your benefits and the level at which
ning at Central States. “Our website has so much informa-        they are paid
                                                                                                            Continued on page 15


 The Magazine of the Central States, Southeast and Southwest Areas Health and Welfare and Pension Funds

                                                                                                            NON-PROFIT ORG
        9377 W. Higgins Road, Rosemont, IL 60018




                                                                                                             U.S. POSTAGE
                                                                                                                  PAID
                                                                                                              CHICAGO, IL
                                                                                                            PERMIT NO. 2987

								
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