July 2017 Welfare Notes

July, 2017

Summary of Benefits and Coverage
A Summary of Benefits and Coverage is being mailed to all Members enrolled in an active medical plan.  Members who are enrolled in the Kaiser Portland Oregon Plan will not receive a Summary of Benefits and Coverage until January 2018 which is the date of the plan renewal.  All other members enrolled in a medical plan will be receiving the updated information within the next few weeks.  This is informational only and does not require any further action from those enrolled.  It is important to keep the Plan office advised of address changes to insure you receive updated information.
Pensioners Annual Allowance
The fiscal year for the Pensioners Annual Allowance runs from August 01 through July 31 of the following year.
The maximum reimbursable totals for the fiscal year are $3,000.00 for medical premiums, $1,000.00 for prescription drugs, and $1,000.00 for other expenses including medical, dental, and vision expenses.  As an example $300.00 in medical expenses, $500.00 in dental expenses, and $200.00 in vision expenses would total the $1,000.00 maximum for the other expenses maximum.
A medical, dental, or vision expense is considered to be incurred on the date you receive treatment or the date of the visit giving rise to the expense.  For prescription drugs, the incurred date is the date you paid for the prescription drug.  For medical premiums, the expense is incurred on the due date for the premium being paid, not the date of your premium payment.
Claims for reimbursement must be submitted to the Plan office within 90 days of the date of incurring the charge or within 90 days of Medicare processing the claim.  The patient’s name, date of services, a description of the services, and the amount charged for services must be indicated by the provider of services on the statement submitted for reimbursement.