The No Surprises Act

In order to protect consumers from “surprise” medical bills, Congress passed the Consolidated Appropriations Act, 2021 (CAA) which contained the No Surprises Act. The No Surprises Act prohibits you from being “balance billed” for Non-PPO Emergency Services, certain services by Non-PPO providers at a PPO hospital or ambulatory surgical center, and by Non-PPO provider air ambulance services. In addition, the No Surprises Act added other patient protections such as Continuity of Care. These new rules are effective beginning on or after July 1, 2022.

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EyeMed Vision Care Benefit

The Fund Office uses the EyeMed network for vision benefits. EyeMed will administer a network of vision care providers (known as the “Insight Network”) on behalf of the Fund. Participants and Dependents who are eligible for Vision Benefits can choose to go to a provider in the EyeMed Insight network and receive discounts on services and materials, such as exams, frames, lenses, and contacts.

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Wisconsin Blue Preferred POS

Effective in January 2024, Participants and Dependents who are residents of Wisconsin will be covered under a new in-network arrangement, called the “Wisconsin Blue Preferred POS.” In the coming days, you should be receiving two (2) new Blue Cross Blue Shield (“BCBS”) Insurance ID cards.

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MDLive is a virtual visit benefit which allows phone and video visits with a doctor or therapist via a mobile app, web browser, or phone.

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Preventive Care

Effective January 1, 2024, the Fund will be recognized as a “non-grandfathered” plan according to the federal law known as the Affordable Care Act (“ACA”). For dates of service on and after January 1, 2024, certain preventive care services and supplies delivered by a provider in the Fund’s medical or prescription drug retail pharmacy network (i.e., “In Network”) will be covered by the Fund at 100% with no “Cost-sharing” to Participants and Dependents covered under the Plan.

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