By now, all participants in the Musicians’ Health Fund have received notification of the changeover from MagnaCare (medical) and Blue Cross (hospital) administration to Aetna, taking effect March 1, 2017. For quite some time, the Fund’s Board of Trustees (BOT) has been hearing complaints from members about claims payment issues. Many have also had issues with their health care providers cycling in and (mostly) out of the MagnaCare network. Thus, exploring alternatives has been a priority of the BOT. Last summer, the BOT authorized the Fund’s outside consultants, Segal Consulting, to solicit bids from all the major health insurance providers, and three submitted bids: Blue Cross, Aetna and MagnaCare. Each of the three presented offers to the BOT in October 2016. After discussion and consideration, the BOT decided that Aetna seemed to be offering the most flexibility and savings, and the least network disruption to members in their bid to administer a self-insured medical and hospital plan for the Fund. The new plans mirror our current Plan A and Plan A+ very closely, while reducing the Fund’s costs and providing a large network to members, which will likely encompass most of our members’ current health care providers.
Aetna has promised the Fund a high level of customer care and assistance, which, when combined with the services of our own Fund office, will hopefully minimize the inconvenience of the transition and any issues our members encounter going forward. We encourage every participant to review carefully the recent Summary of Material Modifications (SMM) and Summary of Benefits and Coverage (SBC) sent by the Fund. We also urge all participants to visit the Aetna web site at www.aetna.com to verify whether or not your current providers participate in the Aetna Choice POS II Open Access network. There has been no change to the Fund’s out-of-network benefit reimbursement, but, as in the past, it will usually cost you much less to use providers who are in-network. If you have questions, please call the Fund office at (212) 245-4802 or e-mail hbp@Local802afm.org.
Finally, those participants who are currently enrolled in the Blue Cross HMO will not experience any disruption as these changes do not affect that plan.
We believe that the transition to Aetna will save the Fund and you money while ensuring a comprehensive plan of benefits and an increased level of customer care, with a minimal amount of inconvenience in the transition period. In an insurance world where health care is costing the individual so much more each year, often for fewer benefits, and where the future of health care coverage is a huge question mark, the Trustees believe the changes discussed here are very good news.
The SMM and SBC for our new Aetna plans were mailed to each participant at the end of December 2016. Copies of these and other documents can be found in the health fund section of our web site at www.local802afm.org/health-benefits.
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