09/19/05 Blue Cross

GA-23000 Participants to Have Blue Cross Blue Shield Option Effective January 1, 2006.

TCU members covered by the Railroad Employees National Health and Welfare Plan (GA-23000) will have the additional option of electing Blue Cross Blue Shield (“Highmark”) as their health insurance provider effective January 1, 2006.

If you reside in an existing Managed Medical Care Program (“MMCP”) network area administered by either United Healthcare or Aetna, you may elect Highmark as your  provider or you may choose to remain with United Healthcare or Aetna. You also have the option of choosing  the Comprehensive Health Care Benefit (“CHCB”) to be administered by either United or Highmark. Members who do not reside in an existing United or Aetna MMCP network area will have the option of electing United or Highmark as their CHCB provider.

The initial election may only be made during the annual Fall open enrollment process. If United, Aetna, or Highmark MMCP is chosen during open enrollment, the participant must remain in that MMCP coverage for the full calendar year. Participants may switch from CHCB to MMCP at any time during the year, but a switch from MMCP to CHCB may only be made on an annual basis during open enrollment. Participants may also switch from either the United or Highmark CHCB plans to any MMCP-designated provider in the area where they reside.

The selection of an insurance carrier to administer MMCP or CHCB plan benefits does not affect medical insurance benefit levels, copays, or deductibles, all of which are negotiated between the participating railroads and rail unions. Choosing an insurance carrier involves selecting which company you want to administer the negotiated benefits. If you are in MMCP, one important consideration is whether or not the doctors and hospitals that you prefer to use are participating in the networks administered by Highmark, United or Aetna. You get the higher benefits of in-network utilization ($15 copays and no deductibles, for example) only when utilizing medical care providers who are network participants. To find out if particular doctors or hospitals are participating in a network, contact Highmark at: www.highmark.com; Untied Healthcare at: 1-800-842-9905 or www.myuhc.com, or Aetna at: 1-800-842-4044 or www.aetna.com.

The annual open enrollment will begin in October 2005 (for the January 1, 2006 effective date), and enrollment kits will include information and instructions on the new Highmark option.

<< return to news front