News Archives 2004

October 20, 2004

Dear Welfare Fund Participant:

Please be advised that the Summary Plan Description (2002 Edition) of the North Central Illinois Laborers' Health & Welfare Fund was recently amended as follows:

Effective August 24, 2004, all references in the Summary Plan Description to "Benefits Administrative Services" are changed to "Medical Group Insurance Services, Inc." (MGIS). The address and contact information will remain the same.

The Fund Office was notified by MGIS (formerly BAS) of this change by letter on September 23, 2004.

MGIS (formerly BAS) has also changed its web address to www.mgis-rockford.com. If you should visit the old website, you will be redirected to this address.

If you have any questions about these changes, please contact the Fund Office

Please keep this letter in the front pocket of your SPD booklet for future reference.

Sincerely,

Board of Trustees
North Central Illinois Laborers' Health & Welfare Fund

visit www.ncilhwf.com for all latest news and information about the Fund!

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update August 6, 2004

Dear Welfare Fund Participant:

This letter is to notify you that the BlueCard PPO Network has become effective August 1, 2004, for those Fund participants who have chosen the Blue Cross Blue Shield of Illinois network. The BlueCard Network offers nationwide access to contracting providers in the PPO networks linked through the BlueCard PPO Program.

The BlueCard program allows Blue Cross Blue Shield of Illinois participants health care benefits across the country. More than 85 percent of all doctors and hospitals throughout the US contract with the PPO plan.

Claims for services received from PPO doctors and hospitals will be sent electronically to Blue Cross Blue Shield, electronically transmitted to the North Central Illinois Laborers' Health & Welfare Fund, and will continue to handle all inquiries about these claims. This electronic process eliminates the need to submit paper claims.

If you are not currently a member of the Blue Cross network and wish to enroll in it, you may do so effective January 1, 2005.

All Fund participants will receive Open Enrollment materials beginning October 1, 2004 and will have until October 31 to respond. Changes made during this period are not effective until January 1, 2005.

If you are a Blue Cross participant and have not received new Blue Cross identification cards or if you have any other questions about the information in this letter, please contact the Fund Office.

Sincerely,

Board of Trustees
North Central Illinois Laborers' Health & Welfare Fund

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update June 2, 2004

Amendments to SPD

Please be advised that the Summary Plan Description (2002 Edition) of the North Central Illinois Laborers' Health & Welfare Fund was amended effective July 1, 2004.

Note that this amendment includes important changes to Plan Deductibles, Out-of-Pocket Maximums and Doctor's Office Visits Copayments, all of which are effective July 1, 2004.

The Deductible, Out-of-Pocket Maximum and Doctor's Office Visits sections in the HFN Exclusive Provider Organization/Preferred Provider Organization (EPO/PPO) Plan Schedule of Benefits are deleted and replaced with the following:

	HFN-EPO Network	PPO Network	Out-of- Network
Deductible
Individual		$300	$600
Family		$600	$1,800
Calendar Year Out-Of-Pocket Maximum
Individual	$2,500	$2,500	Unlimited
Family	$7,500	$7,500	Unlimited
Doctor's Office Visit	$20 Copayment	$20 Copayment	40%

The Deductible, Out-of-Pocket Maximum and Doctor's Office Visits sections in the Health Alliance Preferred Provider Organization (PPO) Plan Schedule of Benefits are deleted and replaced with the following:

	In-Network	Out-of- Network
Deductible
Individual	$300	$600
Family	$600	$1,800
Calendar Year Out-Of-Pocket Maximum
Individual	$2,500	Unlimited
Family	$7,500	Unlimited
Doctor's Office Visit	$20 Copayment	40%

The Deductible, Out-of-Pocket Maximum and Doctor's Office Visits sections in the Blue Cross Blue Shield of Illinois Preferred Provider Organization (PPO) Plan Schedule of Benefits are deleted and replaced with the following:

	In-Network	Out-of- Network
Deductible
Individual	$300	$600
Family	$600	$1,800
Calendar Year Out-Of-Pocket Maximum
Individual	$2,500	Unlimited
Family	$7,500	Unlimited
Doctor's Office Visit	$20 Copayment	40%

Included with this letter are replacement Schedule of Benefits for each of the three networks offered by the Fund. These replacement Schedules have been updated to include the changes outlined here, as well as all other changes to date that appear on these Schedules. Please discard the Benefit Schedules that were originally issued with your Summary Plan Description.

The Medical Expense Benefit section is amended by adding the following section after the Out-of-Pocket Co-Payment section on page 17:

Coinsurance and Coinsurance Limitations

Coinsurance means the percentage of covered charges that is paid by the Plan on your behalf. The percentage is listed in your Schedule of Benefits and may differ for the different types of benefits covered by the Plan. For most covered charges, you must meet your deductible before the Plan pays the scheduled percentage.

When you receive services from in-network providers, the Plan will pay the scheduled percentage up to your Calendar Year Out-of-Pocket limit, and then the Plan will pay 100% of covered charges until you reach the Maximum Calendar Year Benefit. When you receive services from out-of-network providers, the Plan will pay only the scheduled percentage until you reach the Maximum Calendar Year Benefit.

If you have any questions about these changes, please contact the Fund Office

update June 2, 2004

Guardian Dental Network effective July 1, 2004

Effective July 1, 2004 the Trustees of the North Central Illinois Laborers' Health & Welfare Fund have chosen to put the Guardian Dental Network in place for the benefit of all participants and their families.

Enclosed you will find two Guardian ID cards.

By using a Guardian network dentist you will be able to take advantage of slightly higher benefit levels than have been offered by the Fund in the past. However, there has been NO reduction of benefits for those members who choose to use a non-Guardian dentist.

Currently, the Plan pays 80% of covered dental expenses for Preventative Care (Coverage A), Primary Care (Coverage B) and Major Care (Coverage C) Dental Services (refer to pages 34-35 of the Summary Plan Description).

Effective July 1, 2004, the Plan will pay 100% of covered dental expenses for Preventative Care if services are provided by a Guardian network dentist.

You can easily find out if your current dentist is a Guardian provider, or can find a new dentist who is a Guardian provider, by visiting Guardian's website at www.glic.com or calling 1-888-544-2102.

Please note that beginning July 1, 2004, Benefit Administrative Services (BAS) will no longer handle the processing of dental service claims. All claims for in- or out-of-network dental services performed on or after July 1 should be submitted to:

Guardian
Group Dental Claims
P.O. Box 2459
Spokane, WA 99210-2459

You may contact Guardian directly at 800.541-7846 if you have questions about claims, need to file a Pre-Estimation of Benefits form or have questions about the Extension of Dental Expense Benefits.

All other benefits, calendar year maximums, limitations, requirements and exclusions as outlined in the SPD, pages 34-37 continue unchanged.

If you have any questions about these changes, please contact the Fund Office

update April 1, 2004

Amendment to SPD

Please be advised that the following amendment to the Summary Plan Description(2002 Edition) of the North Central Illinois Laborers' Health & Welfare Fund has been adopted:

Change effective April 1, 2004

The last sentence of the paragraph under Temporomandibular Joint (TMJ) Treatment on page 24 is deleted and replaced with the following:

Change effective April 1, 2004 to the HFN Schedule of Benefits:

The Treatment of Temporomandibular Joint (TMJ) section in the HFN Exclusive Provider
Organization/Preferred Provider Organization (EPO/PPO) Plan Schedule of Benefits is deleted and replaced with the following:

	HFN-EPO Network	PPO Network	Out-of- Network
Treatment of Temporomandibular Joint (TMJ)	100%	90%	70%
Lifetime Maximum of TMJ Benefit
Preparatory Work	Benefits payable up to $1,000 lifetime maximum
Surgery	Benefits payable up to $2,000 lifetime maximum

Change effective April 1, 2004 to the Health Alliance Schedule of Benefits:

The Treatment of Temporomandibular Joint (TMJ) section in the Health Alliance Preferred Provider Organization (PPO) Plan Schedule of Benefits is deleted and replaced with the following:

	In-Network	Out-of-Network
Treatment of Temporomandibular Joint (TMJ)	90%	70%
Lifetime Maximum of TMJ Benefit
Preparatory Work	Benefits payable up to $1,000 lifetime maximum
Surgery	Benefits payable up to $2,000 lifetime maximum

Change effective April 1, 2004 to the Blue Cross Blue Shield of Illinois Schedule of Benefits:

The Treatment of Temporomandibular Joint (TMJ) section in the Blue Cross Blue Shield of Illinois (BCBSIL) Preferred Provider Organization (PPO) Plan Schedule of Benefits is deleted and replaced with the following:

	In-Network	Out-of-Network
Treatment of Temporomandibular Joint (TMJ)	90%	70%
Lifetime Maximum of TMJ Benefit
Preparatory Work	Benefits payable up to $1,000 lifetime maximum
Surgery	Benefits payable up to $2,000 lifetime maximum

If you have any questions about these changes, please contact the Fund Office.

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update February 2, 2004

Women's Health & Cancer Rights Act Notice

The Women's Health and Cancer Rights Act requires that we notify you annually that the medical options offered under the North Central Illinois Laborers' Health & Welfare Fund Plan provide coverage for the following after a covered mastectomy:

· Reconstruction of the breast on which the mastectomy was performed;
· Surgery and reconstruction of the other breast to produce a symmetrical appearance, and
· Prosthesis and treatment of physical complications of all stages of a mastectomy, including lymphedemas.

Coverage will be subject to the same annual deductible, coinsurance and/or copayment provisions, and other limitation and exclusions applicable under the Plan.

This information can also be found on Page 19, Item 5 of the North Central Illinois Laborers' Health & Welfare Fund's Summary Plan Description, 2002 edition.