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Special Info - Retiree's Health Fund

2/11/2017

 

From:
Henry Trevino [mailto:htre2003@aol.com]
Subject: Special Info Retiree’s Health Fund
 
Always call Fire and Police Health Care Fund Staff for any questions concerning health care benefits.
Health Care Fund information does appear in the Retiree’s Web page at; http://www.safppa.org.
 
“YOUR FIRST CALL SHOULD BE TO THE FIRE AND POLICE HEALTH CARE FUND OFFICE.”
The telephone number is on your new white Health Care Fund registration card. 
                                                           
Click Read More ----------------------->
 
From: Henry Trevino [mailto:htre2003@aol.com]
Subject: Special Info Retiree’s Health Fund
 
Always call Fire and Police Health Care Fund Staff for any questions concerning health care benefits.
Health Care Fund information does appear in the Retiree’s Web page at; http://www.safppa.org.
 
“YOUR FIRST CALL SHOULD BE TO THE FIRE AND POLICE HEALTH CARE FUND OFFICE.”
The telephone number is on your new white Health Care Fund registration card. 
 
FELLOW AND FUTURE MEMBERS             MARCH 1, 2017
 
         First order of business: TURN in your claims forms.  Your health benefits will not be paid if your claims form is not on file.  Another item: get rid of your old health benefits card.  I have had several calls telling me that Envision does not have their medication records.  Of course they don’t have the records; Envision is not our PBM anymore.  Use the new card that you received through the mail.  If you don’t have a 2017 health benefits identification card call the Health Fund Staff.  Telephone Number: 1-866-652-4237
 
         The new South East clinic is now a work in progress.  It is slated to open on May 1st.  I will continue to give periodic updates on the progress of the clinic. 
 
          The North side clinic is working at full capacity.  While we’re on the subject of the clinic I’d like to remind our members to call the clinic for an appointment in the event that you have to see a doctor as soon as possible.  If the emergency is such that you have to see a doctor immediately and cannot be seen right away at the clinic I suggest that you go to an emergency clinic or the hospital.
 
         I would like a heads up on the Fire Fighters breakfasts.  James Bounds, the Administrator of the Fund and I would like to attend whenever possible so we can give you updates on the new clinic.  My Number is 710-7378.  You can get in touch with James by calling the Health Fund.  1-866-652-4237
 
         I encourage our members to look through the insurance packet that you received at the Insurance Seminar or through the mail.  Two very important items in the packet are the claims form that has to be on file every year and the Plan Document Booklet.
 
         The booklet details your benefits, exceptions, pre-certification, in-network etc.   We have had appeals from our members on benefits that weren’t paid, either because they weren’t covered, they were not pre-certified, or were out of net-work.  Some members, unfortunately, have had to pay substantial amounts of money.
 
         Appeals to the Board of Trustees do not guarantee success in getting your benefits paid.  The Trustees have to base their decisions on the dictates of the Plan Document.  The Board of Trustees cannot make exceptions to the Plan Document.  The Board tries to accommodate some of the appeals but accommodating does not mean making exceptions.
 
         That is why I strongly insist that you get very familiar with your Plan Document or at the very least call the Health Fund Staff to make sure that your medications or surgical procedures are covered.  Information is but a telephone call away.
 
         Have you kept the resolutions that you made for the New Year? If you remember, I asked you to make one additional resolution: a resolution to keep the resolutions you made at the beginning of the year.  Hopefully you will keep and act on the resolution you made about starting an exercise program.
THE LAST THREE OR FOUR REPS IS WHAT MAKES THE MUSCLES GROW.            THIS AREA OF PAIN DIVIDES THE CHAMPION FROM                                                             SOMEONE ELSE WHO IS NOT A CHAMPION.                                                                                                                                                                            (Arnold Schwarzenegger)
 
Moral of the Story:  All we want is to be on our feet when they turn off the switch.  The trick is to discipline yourself to exercise every day and go one step further after the pain begins.  Remember: discipline, discipline, never ending discipline is the name of the game.  


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